


Unfurl in the Wind

by ever_dimming



Category: Supernatural
Genre: CPTSD, Co-consciousness, DID/OSDD, Dissociation, Dissociative Identity Disorder, Emotional Hurt/Comfort, Gen, Hospitalization, Hurt Sam Winchester, Hurt/Comfort, POV Outsider, PTSD, Protective Dean Winchester, Psychological Trauma, Sam with DID, Self-Harm, Therapy, psychiaric ward
Language: English
Status: In-Progress
Published: 2020-12-07
Updated: 2020-12-15
Packaged: 2021-03-09 18:08:05
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 9
Words: 42,694
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/27930526
Author URL: https://archiveofourown.org/users/ever_dimming/pseuds/ever_dimming
Summary: AU (so no specific season). Sam has managed to fly under most people's radar with this for many years, but not anymore. Not since Dean unexpectedly went missing. He's been struggling more than usual, and he finds himself in a psychiatric ward, facing a life-changing diagnosis that he’s long avoided.If you live with DID (Dissociative Identity Disorder) or OSDD, please make extra sure you read the trigger warnings.The title is from Steve Tannen's beautiful songBrother Uptown.TW:⚫ Some self-injury, as well as suicidal ideation.⚫ Psych ward / hospital life and routines.⚫ While this fic handles the result of Sam's trauma and not the trauma itself, it’s not hard to figure out from some of Sam’s more concrete symptoms what he's endured. That can definitely be triggering.For more on the form of DID explored here, see the End Notes.Disclaimer: Don't own Supernatural, just loving on it.
Comments: 28
Kudos: 69





	1. Chapter 1

***I originally planned to only post this fic when it's complete, but due to my deteriorating health I decided to post everything I have so far. So, this is a bunch of chapters I'll be posting all at once.  
I'm still writing, so I hope to get to finish this one.**

____________________________________________________

Kate curls up in her coat as she makes her way into the old building. It’s not even cold today, not really; but she is tired and sleep-deprived enough that she still shivers as she walks into the warmth of the lobby through the heavy glass doors.

Okay, maybe “lobby” is a stretch -- it’s more of a nurses station with a couple of basic, institutional-looking blue armchairs outside it, plus some ancient magazines piling on a tiny table -- but she gets why both patients and staff choose to call it that. Anything to make the place feel less like what it is. 

She can see Sam at the end of the hall, and she watches him shuffle to a corner and stand there. He looks slow this morning, sort of deflated, and for a moment she wonders if they tweaked his meds, or if he isn’t sleeping again. 

But then he flinches at the sound of the main doors closing and looks around, and even from far away, she can tell. Despite his palpable misery, Sam’s eyes are almost always warm, marked with tiny laugh lines at their corners. The kind she wouldn’t have noticed if she hadn’t spent so much time examining his expression, worried, in group and in their sessions. Today, though, that familiar face is slack and his eyes are shuttered windows, not a hint of recognition there. The man at the end of the hall stares at her for a few seconds like she’s part of the furniture, then his gaze drifts away.

Not Sam, then.

Kate chokes back a sigh as she makes her way to the station and taps on the glass, pointing at the door handle. “Morning.”

The nurse grins at her knowingly as she unlocks the door to let her inside. Megan can recognize her hangover face a mile away. “Rough night?”

Kate puts down her to-go coffee cup, shrugs out of her coat. “Nothing major. Just need to get some Advil and some caffeine in me, I’ll be good in a couple of hours. How’d it go in here?”

Her real question is _what happened to make Sam switch so early in the day,_ and Megan knows it. “Well, a few people had a harder time than usual sleeping, especially Ed. So he was coming up to the station a lot — why can’t I give him just one more pill, why won’t I ask the doctor on call to prescribe something, maybe tonight they will. Poor guy just wants to rest, I get that. But sometimes I feel like he thinks I turn into the benzo fairy at night.” 

She looks down the hall, her face darkening a bit. “Yeah, and Sam had another bad nightmare. So that pretty much took care of the rest of the night.”

 _Of course._ Kate doesn’t suppress her sigh this time. “I was about to ask why he’s not - - why he’s looking like that. When did he switch?”

Megan shrugs. “Hard to tell with him. You know, it’s not like his… people? Alters?”

“He calls them his others.”

“Okay -- it’s not like his others announce themselves. You sort of have to guess who it is you’re dealing with, sometimes.”

Kate nods. One of the challenges of learning to treat Sam has been realizing just how subtle or confusing the switches can get at times; nothing like the image of Dissociative Identity Disorder she had in her head when she first started working here. It has her wondering how many people just like Sam she must interact with every day without ever realizing that she’s talking to an alter. Sam told her that once: _your doctor, the cashier in the store, your roommate._ _There’s so many of us out there with DID, and most people blow right past it. They don’t see, not unless there’s major trouble._

Which she supposes he’s in, these days.

“Anyway, he woke up at around 3:30 AM screaming, leapt out of bed and tried to run before he realized where he was. And then he sort of… you know, faded after that, like always. We tried to ground him, but it didn’t do much good. He almost fell on his face when I managed to get him to walk around the lobby for a bit. Legs turned to jello, dizzy, couldn’t talk. The whole nine yards. And he kept dropping the ice cubes, too, so that didn’t help any.”

Having patients hold ice when they’re dissociating is an old trick of the trade, and the cold does work for some of them, but Kate isn’t surprised that it was useless this time. Sam’s younger alters -- she’s come to call them _the kids_ , like he reluctantly does _\--_ don’t exactly share all of his fine motor skills; whatever part of the brain is responsible for those, it’s not cooperating when they’re around. And if one of them was in control at the time, they wouldn’t have handled the task well. 

“Yeah, the others that tend to come out after he’s had a nightmare or a flashback aren’t super coordinated. We should try using something less slippery, like a small orange or a tangerine maybe; I’ve been thinking about keeping one in the back of the freezer here. Ice cubes are just... too messy.”

“That’s actually not a bad idea.”

Kate can’t help but laugh. “Wow, sound **_more_ ** surprised. Come on, I’m not that new.”

Megan fakes a melodramatic eye roll as she closes and locks the medicine cabinet. “Oh, you know I didn’t mean it like that. People here are sort of set in their ways, that’s all -- they’re not all bright-eyed and bushy-tailed like you.”

Kate snorts. “Well, proud to be the psych ward’s resident labradoodle.”

Megan reaches out for the door just as Zach sticks his head in, looking remarkably fresh for someone who’s just coming off a night shift. “Hey, didn’t see you come in. What’s up?”

Kate is too damn tired to bother with smalltalk. “I hear you guys had some trouble with Sam during the night.”

Zach grimaces. “Yeah. I mean, nothing unusual for him, but man, it was _not_ fun to watch.” He rubs his forehead. “The guy’s been with us for what, a couple months now? And I don’t see him getting any better. Guess that’s why they want him out, right. Just as well -- I don’t think Adams even believes him, anyway.” 

The chief of psychiatry’s attitude when it comes to delicate issues like dissociative disorders consistently makes Kate want to pull her hair out. She thinks to herself that Adams probably _is_ behind the plans for Sam’s early release, though it’s not something that would be wise for her to comment on out loud.

She shakes her head. “Listen, you just don’t ‘get better’ in a month or two. Not with this, at least. The guy has a long road ahead of him.”

Zach is one of the sweetest members of a small, mostly hard-working staff, and she likes him almost as much as she does Megan, but every now and again she gets a reminder that patience has never been one of his virtues. “Yeah, but the guy’s gonna get rid of those parts, though, right? I mean, eventually.”

Kate closes her eyes. _Here we go again. "_ It’s really not that cut and dry. We’ve talked about this.”

“Yeah, I know. It’s just - - ” Zach looks down at the grey floor tiles, and Kate knows what he’s about to say next. It seems to be the general response that Sam’s case provokes in people. “I don’t know, it’s just frustrating. I hate to see him hurting like that and not be able to help.”

Kate finds herself studying the floor, too. “I know.”

*

The staff doesn’t eat with the patients, but Kate lingers around the floor kitchenette just the same, pathetically feigning interest in the coffee maker. _You should really stop doing this,_ she thinks to herself, but the thought of going to her office -- if you can call the tiny room that -- depresses her too much. She stays put, feeling guilty. 

Ed comes in first for his coffee, dragging Sam behind him. Some of the patients consistently try to help by herding Sam around when they can tell he’s not all there, which Kate finds sort of heartwarming and heartbreaking at the same time. People tend to develop tunnel vision in the ward, too flooded and exhausted by their own severe distress to have much room for empathy. But quite a few of her patients seem to care about the shy, tall man. Well, except when Jay is in front; no one comes near Sam when that particular alter -- Sam’s protector and somehow also his worst enemy, and the only one who’s been willing to provide her with a name -- is at the wheel. And she can’t say she blames them. 

But it’s definitely not Jay now. Nor is it Sam. With the softness around the eyes, and the way he looks around and down at his legs like he’s constantly surprised at how tall and far away from the ground he is, the man standing a few feet from her looks much younger than his real age. And he still somehow looks disturbingly absent, too. 

“Hey, guys,” Kate says, with as much cheer as she can muster. Which, apparently, not that much.

Ed smiles at her weakly. “Morning.” 

He waits a second, then elbows Sam when he fails to follow suit. 

Sam _(not-Sam)_ shudders and lifts his gaze. Kate finds herself looking for something recognizable in those familiar hazel eyes, but she finds nothing other than the knowledge that it’s most definitely not Sam looking back at her.

“M-morning,” he says, and then thinks for a moment before he adds, “Kate.”

Kate forces out what she can only hope is a convincing smile. _At least there’s some internal communication, someone to pass information to whoever is steering the ship right now._ “Hey. I’m gonna go take care of some paperwork, okay? I’ll see you guys in group. Don’t be late.”

“Okay,” not-Sam says distractedly when she’s almost out of earshot. “Bye.”

Things aren’t much better in group. With the holidays around the corner, the level of stress in the room is palpably higher than normal; meals with extended family mean having to answer questions about work, about relationships, about life, and none of the patients is particularly keen on sharing what they’re going through. Even Ed, who’s been vocal about refusing to hide anymore and about not being ashamed because _fuck them, that’s why,_ is uncharacteristically quiet today. 

Terry raises her arm, looks at Kate and Mateo like she isn’t sure if she actually wants to be given the floor. She’s only been here for around a week, and though she’s spoken a few times during group, it’s still a struggle. 

Mateo nods at her. “Yeah, Terry, go ahead. Tell us how this day is starting for _you_.”

Kate barely manages to choke back an unexpected giggle as she catches Luke rolling his eyes at the prompt. He’s been here long enough that he’s already commented on the staff’s tendency to use "the same, like, three sentences” repeatedly during activities, and he’s not wrong. Maybe they need to add some new ones to their repertoire of Group Therapy Speak.

Terry hesitates for a long moment before she begins. “I’m kind of worried about - - about Sam.” Her eyes dart to the man slumped in his chair in the corner. People tend to meander a little during group, move their chairs to the left or right, some need more space than others. But Sam -- or at least this part of him -- is especially prone to sliding his chair back until he’s literally pressed up against the wall. Kate suspects it has to do with feeling safe, which hurts to even consider.

Mateo raises an eyebrow, and she knows before he speaks what he’ll suggest: that worrying about another patient might be easier for Terry than addressing her own issues. A cliché, but not a rare tactic here, for all the emotional blood-and-guts and no-pretense expectations some patients -- and staff, for that matter -- come in with. Coping mechanisms don’t just take a break based on location; and people who've spent years avoiding their own wounds by being everyone else’s insistent medics can be tough to pin down. Hard to convince them to address their own pain, even when they’ve checked in seeking help for it. 

Kate only half-listens as her colleague says exactly that, her eyes still on Sam. Well, not truly Sam. Right. _Who is this? I don’t think we’ve seen this one._

But Terry gets some unanticipated backup, a few people nodding along and mumbling. Apparently Sam’s lapses have more of an effect on the group than either of them realized. Not good. 

Mateo sighs. “Okay, I see this is an issue for more than one person today. Let’s talk about it. What are you worried about? Sam, you can jump in at any point if this is uncomfortable, let us know how you feel. Obviously.” 

Kate knows he’s only addressing the dissociated man out of decorum, mostly to avoid a blatant talking-over-someone’s-head situation. Mateo knows full well that Sam isn’t really there, isn’t really hearing any of this. And if he is, he won’t be able to respond; he’s locked away.

This doesn’t feel good, but they need to address the elephant in the room, now that it’s been brought up.

“I know I haven’t been here long, but I keep - - ” Terry looks like she’s considering her words, like she’s been thinking about how to phrase this. “I keep seeing Sam go through these, umm, I guess you’d call them episodes? I don’t really know. Times when he’s really out of it, like right now. And times when he seems fine, but if feels like something’s off. And it gets to me. I don’t know what’s going on, but it seems painful. I feel like - - ” she moves uneasily in her seat. “I feel like you guys need to pay closer attention to what’s going on.”

Kate feels a petty, almost childish spark of annoyance at the suggestion that they’re not doing their job, but she reminds herself that big professional egos don’t last around here. _Well, not totally true, if you consider Adams._

“You feel like we’re not really on the ball,” Mateo says, and Kate is relieved to hear the hint of a sour note in his tone, too. Probably not as detectable to others as it is to her, and even that's only because she was listening for it -- he knows to keep his ego in check, too.

Terry hesitates. “Well - - no, not saying that, it’s just that I don’t get how we can just go on with group while someone is…” She struggles for the right words, finally settles for gesturing vaguely at Sam’s slumped form. “You know, like this.”

The debate that follows is nothing new to Kate; six months in, she’s sat through enough group dynamics to foresee at least the general trajectory of most conversations. One of the first things she noticed here was that, even when preoccupied with their own misery, most people can only take so much of someone else’s silent-yet-evident crisis before they get antsy. Before they demand the staff’s attention. Talkers don’t usually garner that reaction -- they’ll get feedback, sure, sometimes provoke arguments, but other patients don’t rally around them. Most days, only about half the room is fully listening while someone is talking; people are consumed by their own pain, or thinking about what they want to share next, or anxious about having to speak. But it’s when someone isn’t talking at all, when someone seems to drop off the radar completely, that everyone gets increasingly uneasy. And she gets it. 

“Terry,” she says, “look, I know it feels like we’re abandoning a group member when you see the way the discussion just keeps going, with Sam unresponsive like that. I really do understand that. But we can’t stop group to tend to one person -- that’s A.” She exchanges a quick glance with Mateo, who gives her a tiny nod. “And B, part of Sam’s work here is to manage his condition. We do see him, trust me. We do worry about him sometimes. But I can promise you, if we’re not addressing someone’s silence or distress, it’s not because we haven’t noticed. Does that help a little?”

Terry sinks in her seat. “I dunno, I guess. I just - - “ she avoids looking at Sam this time. “I was wondering, is all.”

“That’s perfectly understandable. Maybe this is something you can bring up when Sam’s more present, ask him directly. In group or somewhere else.”

A shrug. _Yeah, probably not. Okay._

They move on, and by the time the discussion nears its end, everyone seems to have made peace with Sam’s current state. Even Terry. Luke, who’s sitting by Sam like always, appears the least concerned; Kate finds that weirdly reassuring, since he’s probably Sam’s closest thing to a best friend in here. On the few occasions that shit really hit the fan -- like the time when there was blood and talk of transferring Sam to a locked ward -- Luke was so distraught he almost needed to be sedated himself. She decides to take his nonchalance today as a good sign, watches him swing his legs back and forth below his chair the way he always does when he has to sit for too long. The guy has way too much energy for this room. For most rooms, probably. She wonders if he's getting hypomanic again, now that they've started tapering down some of his meds. He's been begging for a change, saying he’s too numb to know he's alive, and oh, Kate remembers what that’s like. She hopes for his sake that this _is_ just a high energy day, not the beginning of another spiral. 

She can sense Mateo’s gaze on her -- _time to start wrapping this up --_ and nods at him. “We’ve got a few people here who haven’t spoken today,” she says, “I’d love to hear from you guys about how you’re doing right now. Even a word or two, if you can, okay?” 

She doesn’t see it coming, of course. No way to, it’s mostly bad timing -- a door slams loudly down the hall, and Luke flinches, his foot just missing the leg of his chair and kicking Sam’s ankle instead. Not hard, just hard enough. 

Sam’s eyes snap open. There’s a flash of rage that’s almost too quick to catch, dark and all-consuming, and then there’s a strange flatness that takes its place as he looks down, and back up at his roommate. 

Luke flinches again, bites his lip before he says, “shit, sorry, man.”

The hazel eyes that turn their gaze away from him like he’s a minor annoyance aren’t Sam’s, and as they lock on her face and narrow, calculating, she realizes who has taken the wheel. Not really that surprising, considering Sam was unexpectedly pulled out of a blur and into a flash of pain. It _would_ be Jay. 

She makes a conscious decision not to look back at him. “Okay, guys, we have four minutes left. Anything anyone wants to share, real quick, before we wrap this up?”

After the group disperses, with no one approaching Sam and Luke’s corner on the way out -- _they can all tell,_ she thinks _\--_ Mateo rests a hand on her arm. “You have a one-on-one with Sam after art therapy today, right?”

Kate sighs, checks the doorway before she speaks. “Yeah. Can’t honestly say I’m looking forward to it, right now.”

Mateo smiles at her, a little too amused by her resentment. “Jay’s your patient, too, you know. You treat Sam, you treat all of them. Package deal.” 

She frowns, folding the page she’s been scribbling the group notes on. “Yeah, thanks, Sherlock. I’m well aware. It’s just that the guy would probably prefer waterboarding to talking to me about feelings he doesn’t think he has.”

Her colleague shrugs. “Maybe he really _doesn’t_ have any. I’ve never seen him look like there’s too much going on when he’s in front, have you?”

She sighs again. “Nope. I guess Jay wasn’t made for that.” 

“So talk to him the way you would to your average, emotionally stunted a-hole. I mean, that’s what I do. Seems to work fine for him.”

She laughs in spite of herself. “Oh, yeah? You and Jay best buds now?”

Mateo shrugs. “I think he’d be offended by the suggestion that any of us are even fit to be his friends. I don’t think he _has_ friends. Certainly not in here.”

 _No surprise there,_ Kate thinks, and she has to remind herself again that every one of Sam’s others was created for a reason. That this attitude isn’t fair. Somewhere, at some point, Jay probably saved Sam's life. Maybe still does. He’s the way he is because Sam’s system needs that, or needed that when he came into being; and he gets to be heard, too.

She nevertheless finds herself hoping for another switch before it’s time for their session. And she feels guilty about that, too.

*

She can tell Sam isn’t back yet before her patient even finds his place on the couch. _Getting better at it._

“So, I’m talking to Jay, right?” she says, and watches a joyless grin flit across the face of the man in front of her. He nods curtly. “Yep.”

Always short and to the point. Name, rank, serial number. It’s frustrating to work with this part of Sam, to know that the guy doesn’t trust her enough to give her anything she doesn’t specifically ask for. If that. 

She studies his face, and though she knows it’s still technically Sam she’s looking at -- his body, anyway, and someone with whom he shares an inner system -- she’s as unsettled as ever by the difference that she can’t quite put her finger on. Nothing dramatic or obvious; it rarely is as visually jarring as what she was expecting back when she started her major, after a lifetime of movies and TV shows where all people with DID had alters that were easy to tell apart right away, and who -- conveniently -- always had just enough time to change their hair and wardrobe to let you know who you were talking to. 

Took her a while to learn that not all people with DID did that to begin with; that even the ones whose alters do prefer to change the body’s appearance as much as they can, don’t always _get_ to. Certainly not in the hospital. That nothing is ever simple.

It seems obvious, now -- that a life of hiding in plain sight might make some alters far harder to recognize than you’d assume. Certainly the ones who aren’t children. She’s learned to often go by body language, by subtle changes in vocabulary, by each alter’s pattern of speech; by how they flinch or don’t, how (and if) they look back at her. The kind of variants that you need to know someone to really notice.

Which is why it took her a while to be able to tell Sam and Jay apart, why it took spending enough time with them both. Easy to assume you’re still talking to Sam, just in a different mood (okay, a _very_ different mood). Angrier somehow, more assertive and blunt, but at the same time weirdly flat and casual. Less concerned about consequences. Now that she knows Sam and his others a bit, though, the change is clear as day to her. And strangely painful to watch. 

Jay studies her right back. Sam has a hard time maintaining eye contact even when he’s feeling relatively safe, but not this guy. “Something you wanted to ask me, doc?”

 _Doc._ She’s forgotten about Jay’s habit of calling her that, and a bit snidely, too. “Yeah, there’s actually something I’ve been thinking about asking you. Would you say that you feel like the body you’re sharing with Sam... that it represents you?”

Jay raises an eyebrow, lets out a bitter chuckle. “That’s an interesting question. Been eyeing this body lately, have we?”

She doesn’t bother to take offense. “Come on.”

Jay rolls his eyes like he's saying _fine, I'll bite._ “No, this body doesn’t really look like me.”

“And it bothers you.” She probably should have phrased that as a question, but she can’t imagine that it wouldn’t. 

The man shrugs. “I guess so, but not that much. I mean, it’s a body, right? It’s pretty much just the random pile of meat you're stuck with, what you move around in. Not that big of a deal, as long as it’s working okay. I don’t exactly spend my time checking myself out in the mirror.” His smile is probably meant to be amused, but it falls short. Most things do with Jay, somehow; feelings aren’t his strong suit. 

_Random pile of meat._ Kate’s eyes wander over to the edge of the bandage that peeks from under the man’s sleeve, a recent reminder of what Jay is capable of putting the body through. She supposes he’d have to feel that disconnected in order to be able to take a knife or a lighter to his own skin. _To Sam’s skin. Does Sam at least think the body is his, or was that notion beaten out of_ **_him_** _, too?_

She tries to move away from the thought, for now. “So how do you look? I mean, in your head. How do you _feel_ like you look?”

Jay rearranges himself on the couch and yawns, already more at ease in her office than she thinks she’s ever seen Sam. He shakes his head. “Man, I’m beat. Someone stayed up all night again, right? One of the kids, I'll bet.”

“Jay -- ”

“Okay, Jesus. I’d say I’m about Sam’s height. Not as thin. Darker hair, brown eyes, I think. And definitely not the same haircut.”

Kate can’t help but smile. “Yeah, you do seem more like the buzz cut type. Okay, that sort of paints a picture.” She hesitates for a moment, but decides that she can't pass up this opportunity to get some background info while Jay is in this rare, accommodating mood. “And how did you get your name? Do you know?”

He stares at her for a long moment before he answers. “It’s not really a name, just a letter.”

Oh. “So Jay is really just the letter J, then? Which stands for what?”

The man shrugs again. “I don’t know, whatever. Pick a name. John, I guess.”

Kate takes her time watching him before she says, “your father’s name.”

Jay stiffens for a second, like he’s just now making the connection. Then his face darkens. “Not my father. Sam’s, maybe. And even that was a part time job.” 

Kate decides to press the issue. “You think it’s a coincidence, though? That you go by the first letter of your d - - of John’s name?”

The stare she’s rewarded with is ice-cold. “Quick tip, doc. We're not playing a round of _Scattergories_ , here, okay? That sort of crap won’t get you far. Trust me on this.”

A line has definitely been drawn in the sand. Kate curses inwardly at her own indiscretion, getting Jay’s message loud and clear. _Maybe keep your half-baked theories to yourself, next time._

“Listen, it’s not - - is that how you think I see you guys? Like a game, an exercise? Because I don’t, Jay. I can promise you no one here does.”

He looks away, and she knows she’s lost his interest for the moment, that she’s been deemed potentially harmful and is therefore shut out. “Fine,” he says dryly, “you don’t. We’re almost done for today, anyway, right?” 

They actually have well over half an hour left -- she can’t tell if the miscalculation is the result of a lapse in Jay's time perception, or just one of his evasion tactics -- but she’s learned not to push beyond a certain point. Not when Jay’s in charge of the body, at least; she might insist more with Sam, or with one of the other alters.

“You’re always free to go if you want to stop a session, you know that.”

Jay gets up, doesn’t linger by the door the way Sam or the kids do. He certainly doesn't seem to share their problem with goodbyes. She supposes Jay isn't familiar with the sort of desperation that keeps some of the other alters hanging on, struggling with leaving the room and remaining alone with their inner turmoil. Jay is the system's problem fixer -- an effective, blunt and undiscriminating tool, that snuffs out that sort of pain the way he does any other emotion.

“I’ll go check what’s for lunch,” he says on his way out, not sparing her another look. Already focused on his next task. _Not a bad idea, to be honest,_ she thinks. Jay is probably the only one out of Sam’s parts who actually enjoys eating; Sam’s appetite comes and goes -- not that she can blame him, with the food here -- and most of his alters are either too scared, or too distracted to sit down and eat. Some can’t seem to tolerate the idea of consuming anything at all, like the body wires its jaw shut as they filter in.

She remembers watching one of them, a young woman who wears Sam’s body like a punishment she thinks she's earned, cover her mouth in the dining room one morning. She was trying to fight a wave of nausea after Zach had talked her into having some scrambled eggs and toast. Kate remembers the color drain from Sam’s face, the shallow breaths that the girl under his skin was taking as she stared up and away from the plate on the table. _Okay, you’re okay,_ Zach was saying, _I’m gonna take this away now. Just keep breathing._

Kate has seen that sort of visceral, physical response before; some of her patients struggle with even brushing their teeth, for the very same reason. _Nothing is ever simple._

The sight was yet another reminder of why Jay was so crucial. She suspects that one of his main jobs is to handle all things physical, starting back in different circumstances. She’s seen him take the wheel almost every time Sam needed to endure medical checkups and procedures now, all these years later -- when it’s safer for Sam’s body, but not for his mind -- and she imagines that this is the system’s way of avoiding being flooded all over again by whatever horrors the body was subjected to in the past. Jay makes sure old wires don’t get tripped, or at least intercepts the consequences when they do.

She considered that for a while that day before she decided that she didn’t want to think about it anymore, for right then. There’s a surprising amount of things about Sam and his life that she’s found herself doing that with, and she gets the feeling that she isn’t the first; she needs to watch that.

Jay fades away some time during the afternoon. Kate raises her head from the paperwork piling on her desk just in time to see a familiar form making its way slowly down the hallway, and she can tell that by now it's Sam, again. He tends to walk like he doesn’t really expect to reach his destination. That’s one of his giveaways -- his shuffle lacks Jay's focused energy, even on good days. The child alters have their own giveaways, too, once you know to actually look: the younger ones seem slightly less steady on their feet, occasionally even reaching out to touch the nearest wall for balance, which has gotten Sam strange looks from both other patients and newer staff members. Every once in a while, when it’s especially bad, someone will still ask her if Sam is ill, or comment that he must be on some new medication. Which is almost never the case. 

“Sam,” she calls out, and then can't help but smile a little as he peeks his head through her office door, visibly delighted like he hasn't already seen her a few times today. She reminds herself that **_he_ ** hasn't. 

“Oh, hey! Didn't know you were in,” he says, and she notes that he’s absently rubbing his forehead again as he leans against the door frame. Probably trying to ignore another one of his headaches. “Did I - - did we talk? I feel like we talked. It's Monday, right?”

She nods. “Yeah, Monday afternoon. You weren’t really present when I came in this morning, and then we did have our session -- I spoke to Jay.” She watches Sam’s face, and isn't surprised to see it fall. 

“Oh,” he says, and then, instinctively, "sorry. I mean - - was he an ass to you? He usually is.”

Kate laughs. “He wasn't exactly warm and fuzzy, but it went okay. I learned a few new things about him.”

“Yeah?” Sam’s eyes don’t meet hers. She figures he doesn’t want to know the details just yet, and that, too, is hardly a surprise. She decides to change the subject.

“You excited about visiting hours today?”

Sam’s eyes have nothing but blank confusion to offer. “Excited?”

He’s already forgotten. “Your friend said he’d be coming today, right?”

Still nothing. “My - - my friend?” 

He seems stuck. _Must be a bad day if he’s not even managing to hold on to that,_ she thinks. Sam hasn’t had visitors other than this one guy, so it’s not like he can lose track of who she’s referring to _._

“Cas,” she says, and watches Sam’s eyes go wide and bright, like he’s suddenly on the verge of tears. He stares at her for a moment before he can get the words out.

“Cas - - Cas is coming? That’s today?” For the first time in a while, he sounds almost hopeful. 

It’s hard to smile with your heart in your throat, but she thinks she does a pretty good job. "Yeah. He's a good friend, right? You guys go way back?"

Sam nods, swallows hard at the tears that he clearly wasn’t expecting. Takes the tissue that she casually holds out for him and crumples it, embarrassed. "Thanks. Yeah, he used to work with Dean and me, before - - before."

She has yet to get a straight answer out of Sam, or any of his others, about what line of work he and his older brother were actually in before Dean went missing. Or _how_ he went missing. The whole topic has proven risky, and any discussion is inevitably cut short: a few sentences in, Sam will just stop tracking. It makes her sad every single time, as she watches him start to blink and lose his train of thought, his mind stalling under some unbearable pressure that makes remembering impossible. And then it's a matter of seconds before she can see the shift of someone else taking his place. See his system’s defenses locking in, sending forward either Jay -- who tells her in no uncertain terms to keep away from that topic -- or a nervous child, whose paralyzing, helpless panic at the thought that his older brother can't be reached is a reminder of just how few anchors Sam must have had growing up. How few he has now.

She sometimes considers using Sam’s permission to sit down with Cas and talk to him about it. She wants to question _him_ about what exactly happened to Dean; about whether he’s truly missing or actually dead. Whether Sam’s switches were as obvious as they are now throughout the years in which the quiet, pensive man has known him. But today isn't a good day to bring that up.

"Well, I'm glad you have him, a visit will probably be good for you.” She studies Sam’s face, noting that he’s too pale, again. “Did you end up eating anything? At lunch? Jay was headed there when I saw you, before."

She watches as Sam searches his memory, and she can't help but wonder again how it feels to not even know _that_. To need clues in order to know what your body has been doing. 

Sam sighs. "Well, I _feel_ full, and there’s this taste like - - I don't know, like I had some kind of a dessert, maybe? So my guess would be yes, he did have lunch."

Jay has a major sweet tooth, which she suspects he shares with Sam, except Sam seems almost spartan when it comes to anything that he might actually enjoy. Jay, on the other hand, can inhale two or three pudding cups without batting an eye; he would probably prefer that to other food. Either way, this means Sam’s body at least got _some_ sustenance. "Okay, good. I'll check with the staff just to make sure. I hope seeing Cas makes today a bit better."

“Yeah.” Sam gives her that half-smile of his again, and it’s so uniquely his, the trace of a flashlight struggling to break through thick, dark fog. So different from Jay’s icy grin that never reaches his eyes; and so different from the way some of Sam's child alters smile, at least the ones who are shielded from his worst memories -- still trusting and unwounded and unaware of just how carnivorous the world is. 

Sam the adult, the Sam who houses all of those parts and who struggles to come to terms with their existence, smiles like it hurts. Like he’s trying. And it’s still enough to make her desperately want some damn relief for him. It makes her think of how he could be if he’d grown up somewhere else, somewhere safe. If he had grown up to be a version of himself for whom smiling is a casual thing, rather than a chore. Or a leap of faith.


	2. Chapter 2

**Summary for the Chapter:**

> **See the fic summary for trigger warnings and disclaimer.**

Castiel -- what an odd name, too, goes with the man's slightly unusual vibe -- arrives right at the beginning of visiting hours, first one in, like he's been waiting outside for the very second when he’s allowed to enter the ward. Maybe he has been. He and Sam hug awkwardly, but still warmly enough that Kate can tell there's history there, there's real friendship and worry and trust. _Good_. 

She waves at Cas from the end of the hallway, but doesn't come over -- maybe later, not right away. And then she watches the two men make their way to the elevator, probably heading down to the cafeteria or some bench outside, to talk in a more pleasant environment.

She goes back to her office, throws herself back into paperwork and makes it through a particularly bad staff meeting; no time to check on Sam to make sure he's okay after visitations end. That's always a dangerous time for him -- there's often a wave of devastation that seems to hit when his one friend leaves and he stays behind. Like Sam somehow re-assesses where he is, like he's sure he'll never get back out. 

She tells herself that this is, after all, a psychiatric ward, and the staff here is well aware of Sam's volatile state of mind. Someone will notice if things get too bad. She can't be Sam's constant guardian in here, no more than she can be outside. And she wouldn’t be doing him any favors by doing that, anyway.

But when she’s finally done with the paperwork for today -- just for today, there's no hope of ever conquering the mountain of forms that's piling up on her desk and spilling over to the chair in the corner -- she does find herself looking for Sam. Just to make sure. 

He's not in the dining room, nor is he in his room or in the lobby. Kate can feel her pulse pick up as Megan tells her that she hasn't seen Sam in the last hour or so. "He went to his room after his visitor left. I was gonna check in just before dinner. He's not there?"

"No. Not in the dining room, either, and there’s no one in the showers."

Megan frowns. "Well, we know he couldn't have gotten out without us noticing, so he's around here somewhere. Did you check in Art? He likes to go in there to look at the works, sometimes."

 _Of course._ "No, don’t know why I didn't think to look there. That's a good idea. Thanks." 

She does find Sam in the corner of the art therapy room, huddled just behind the half-open door. He looks like he was trying to make himself as small as possible to avoid detection, and then realized it was useless and gave up; his right arm is wrapped around trembling knees that he’s somehow pressed against his chest, and the left one is trailing down onto the floor. He's staring into space when she enters, breathing raggedly, eyes far away and terrified. 

Then his gaze shifts to her face, and she makes herself stay calm as he seemingly tries to recognize her. 

"Hey,” she says, “there you are."

Sam -- _is it_ Sam? -- blinks at her, says nothing.

“Do you know who I am?”

He blinks again, his eyes wandering. “Forgot - - forgot your name. S- sorry."

She crouches down to sit next to him on the carpet. "But you remember who I am?"

A quick nod. "You're, y - - you're okay. You like us."

She can't help but smile. Sam can be painfully shy at times, especially when it comes to naming feelings, which she gets the impression he’s never had much practice in discussing. But some of his others can be jarringly honest. At least this time it's over something positive. "I do, I like you guys a lot. Glad you remember that. My name's Kate."

Sam's face lights up with relief. "Oh." He rests his chin on his knees, repeating the word like he's afraid it might slip out of his memory again. "Kate."

"Yeah. So, why are you sitting like this, in the corner? Did something happen?"

The way his eyebrows arch in surprise tells her he hasn't fully noticed where he is yet. "What?"

He looks down, then around him. Blinks again. "Oh. Umm. I don't - - I was scared, I think."

She takes note of how fast his breathing is, of the fact that she can see his pulse hammering under the pale skin at the exposed side of his neck. He's probably coming down from a bad panic attack. Probably why he dissociated, why he went seeking shelter like that.

Sam -- or whoever it is occupying his body at the moment -- moves uneasily, frowning. Something about realizing where he's sitting seems to have rattled him, and Kate sighs as she watches him wrap his other arm around his knees, hugging them protectively again. He's still wearing his boots, which he rarely bothers with inside, opting for softer shoes or (if Jay is fronting) just his socks. This tells her he probably wasn’t doing well when he came back in from wherever he and his visitor had gone. If she had to venture a guess, it would be that Sam struggled to hold it together through the visit, fighting to stay present until he and Cas said their goodbyes. And that he then started unraveling once he was alone again. 

That he hid, because it was the only thing he could think of to do when his mind started to slide. Makes sense for someone who instinctively equates other people with pain, like so many parts of Sam do.

She’s seen it happen before. Visitors are a distraction that most patients hold on to in here, but their movement in and out still upsets the flow in ways that have very little to do with ward logistics and schedules. Visits from friends and family bring with them reminders of a life that’s been put on hold. Of the reality that got people here in the first place, sometimes; of a world they’re not all sure how to fit back into once they leave. 

But she can’t ask directly about that, not right now. She can see Sam receding even farther, his eyes taking on that opaque, almost underwater look, and his face somehow shedding years. She knows better than to attach anything mystical to this process -- just changes in muscle tension, the way micro-expressions differ for each alter -- but she gets why people are taken aback by it; knowing the mechanics surrounding a switch doesn’t make it any less unsettling to watch.

She doesn’t reach out to touch his arm, though she wishes she could, wishes she could reassure him with something other than words. "You okay? You look scared."

Sam nods. "S-scared." His breath hitches, and he closes his eyes.

Definitely sounds younger. This might be an alter, or it might be Sam temporarily regressing, still present but disoriented. "Any idea why?"

He shakes his head. "Scared," he repeats, and she watches helplessly as he digs his fingers into his knee, increasingly frantic. His shoulders twitch as a sudden roar of laughter floats down the hall, and he looks like he was just slapped. _Not good not good._ "Okay, hey. That’s just Larry, he’s always loud like that, remember? You’re good. Perfectly safe. Look at me.” 

He doesn’t seem to hear her, eyes wide with panic, watching the door like he’s trying to prepare himself for some monster that’s about to charge through it. She is used by now to the wounded children who come back to inhabit the adult bodies of her traumatized patients’ during flashbacks, still dreading the grownups that scarred them; not just her patients with DID, either. She knows how it usually goes, and she’s seen that look of terror, knows full well that logic has no place when fear takes over like that. No point in saying _monsters aren’t real_ when you know what human beings are capable of, no point in saying _no one’s coming for you_ when a patient got here due to a lifetime of learning the opposite.

She finds herself moving uneasily as she wonders, again, what name she can use to get the pained man's fading attention. It would be easier if Sam’s others all knew their own names, but he isn't her first patient whose alters aren't all easily identified, and he won't be her last. 

She has the urge to just say _kiddo_ , the way part of her wants to, the same part that aches to comfort these terrified child alters every time they emerge. But she knows she can’t; someone in Sam’s life may have already used the word -- even worse, a manipulative abuser might have, they too often replicate affection well. It might be a loaded gun. And also, well, because boundaries. _You are not his parent, not his big sister. You can’t be that involved, that close. Stay on top of this, he doesn’t need more of his boundaries crossed._

As she thinks this, the person that Sam has now taken a back seat to suddenly quiets down, stops moving altogether. He stares down at his hands for a long moment, like he isn’t quite sure if they really are his own. 

"Nightmare," he says like it just occurred to him, suddenly appearing relieved. "I'm having a nightmare. It's okay. Dreams can't hurt you for real, don't worry. Don't worry."

 _He's repeating something he’s been told,_ she thinks. _Trying to regain control of the situation._ It makes her wonder if Sam had someone trustworthy that he did cling to through whatever chaos his childhood was, someone who at least tried; maybe the brother.

Or maybe these are just words of comfort that he heard here, in the ward. Maybe there was no one at all to say them to Sam when he was a child. The thought of that kind of loneliness is not something she has time to linger on right now, which she’s grateful for.

"Sam," she says gently, her hand hovering over his arm _don't touch don't touch not right now._ "You're actually not dreaming. You're just a bit dissociated."

He looks up at her, suddenly seeming almost angry. "Not S- Sam."

_Shit. Right._

"Sorry. Force of habit, I guess. Who am I talking to?" 

The boy -- she’s sure now that it's a young boy, though it was obvious enough before -- shrugs, his gaze dropping. "Dunno. Don't - - have a name."

No news there, then. "That's okay. How old are you?"

A shrug. He seems tired and confused, and she tries to imagine not knowing her own name or age. How that would feel. She can't.

"Do you know where we are?"

The boy nods this time. "Hospital."

"That's right. Do you know why you're here?"

He looks almost offended. "Yeah, 'course. Because, because of him. He doesn't want to live anymore. He wants to go away."

Kate's mouth goes dry at the sound of the words. "Sam does?" 

Another nod. 

"Still?" 

They've been well aware of Sam being at high risk, especially since he knew -- same as they all did -- that he'd be going back to a life that’s painfully unsuited for his needs once he's released. He has his friend Cas, but she gets the impression that the guy isn't exactly capable of financially carrying them both even if Sam asked him to, which he wouldn't; and that's about it. From what little information she could gather, Sam has no money, no stable place of residence -- and _of course_ he never filed for disability because how would he, when things are so unpredictable that even keeping track of the day is a challenge. She’s tried to help with that, at least, and they’ve applied on his behalf. But red tape and the constant state of crisis he’s in have made progress worryingly slow. He’ll be flying without a net out there. 

Sam wanted to die before he got here, of course; he was exhausted and flooded and feeling hopeless. Still, she was hoping his time in the ward might have helped bring back some of that will to survive that's kept him alive against the odds for so long. But it sounds like it hasn't, and though she isn’t surprised, the knowledge is still like a punch to the gut. _What have we done for him, then?_

"Just a nightmare," the boy repeats, and the certainty in his voice breaks her heart. She reaches out with one open hand, slow enough that she won’t startle him. "Hey, maybe we can get up off the floor. You think we can do that?” 

She reminds herself that she needs to sound casual to defuse his fear of moving, that it’s best to get his attention on something else. “This carpet is so bad," she adds, exaggeratedly scratching her ankle with her other hand and making a face. “Itchy, right?”

She didn’t outright mean to sound comical, and so the smile that spreads across Sam's borrowed face is as surprising as it is heartwarming. Some of his younger alters are quick to laugh, distracted or amused by things that she never gives a second thought to. She supposes it has to do with the fact that some of them _are_ children, when it comes down to it.

“Yeah,” the boy says, sounding slightly mollified now, "we can get up."

“Yeah? Good. Let’s do that, then.” 

Sam is significantly heavier than she is with his height and build, and normally he wouldn’t accept her offer to help him up, but the kid that reaches up and takes her hand probably doesn’t have a full grasp of the frame he’s residing in. She braces herself as he struggles up, smiles at him as he straightens his back and looks down at her, confused. “Y - - you’re small.”

“I _am_ kind of short, yeah, and mostly you’re really, really tall. You forget that a lot.”

He nods slowly, looking like the idea of it disturbs him. “Don’ like it.”

“You don’t like being this tall?”

He shakes his head fiercely.

“Because you feel little?”

A quick, distressed nod. 

“Yeah, I get that. That’s okay." She's familiar with the misery of these children, their confusion -- and often their open sorrow -- over being trapped in bodies that don't match. _Distract him, don't let him panic._ "I was just going to get myself some coffee, how about you come with? You can sit in the nurses station for a while, if you want. With me and Megan.” 

She knows Sam’s young alters (or Littles, the informal term that she learned from another patient when she first got here) sometimes feel unsafe with so many people around. Too many folks who might approach them thinking they’re talking to Sam, too much activity, way too much noise. 

The kid nods again, wiping his runny nose on his sleeve. "Do we - - do I have a cold?" 

“I think you just cried a little, before," Kate says gently. Then she adds, as she sees his eyes widen in alarm, "crying is allowed though, right?” 

That gets her another dutiful nod, but the boy in Sam's body seems unconvinced, biting his lip and looking guilty, blinking hard to get rid of all possible traces of tears. As she walks him back to the nurses station and leaves him with Megan to go get the coffee, she wonders who it was that once taught Sam not to cry; if they punished him when he did. 

It's been painfully evident that punishment is, and has always been, the central axis of this tortured man's life. Fear of retribution is a common theme with all of his alters, so much so that it's rendered some of them mute. She spent a rough hour trying to communicate with Sam back when he first arrived in the ward, getting only desperate silence as she carefully tried to ask what was going on. Sam told her later -- after she reminded him of the interaction, which took considerable effort -- that it must have been one of his youngest alters, a child about whom he could tell her virtually nothing. He vaguely remembered bits and pieces of her attempts to communicate with the kid -- "sort of like remembering someone else's dream," he said -- but could offer no explanation for his terrified silence.

"I don’t know why he never talks. Feels like he's really young, too. Almost like… like kindergarten age," Sam said. "Is that crazy? It's not possible, right? There's no way I can - - we didn't all exist all the way back then. There’s no way. And also, he… Cas says that sometimes this kid seems to mentally grasp things that a small child wouldn't, and he can write, too. Not well, but he can. It’s like his age is all over the map. It doesn’t track; this can't be real. I really think it isn’t _._ "

It's been a consistent challenge to get Sam to trust himself, to not assume that he's unconsciously making all of it up for some imagined secondary gain. She gets the feeling that he’s been subjected to a lot of that narrative throughout his life; it's a wound that most, if not all of her DID patients have in common. Most people are instinctively -- and sometimes aggressively -- resistant to the notion of a mind that's so divided. And the alternative explanations they offer to DID are devastating, because they all assume a form of fakery is involved. She's been doing this for a relatively short time, but she's already become painfully aware of _that._ The only element that really varies is how openly accusatory people's theories are: it runs the gamut from straightforward suggestions of malingering, to the ever-patronizing, pseudo-empathetic fascination with "what people can make themselves believe''. She's also had the chance to encounter another golden oldie -- and a favorite among certain types of families, it seems: the therapists-implanting-ideas in patients' minds explanation.

All these forms of invalidation or plain denial make her blood boil way more than is professionally healthy for her, if she's honest with herself. And it can be a true challenge to stay cordial when she finds herself engaged in that type of a discussion. Say, with Adams. Something about encountering that sort of glib dismissal among fellow mental health professionals is especially hard to swallow. She wouldn't mind the ignorance as much if it weren't for the fact that it guides those who make crucial decisions about people like Sam. 

Either way, in direct correlation to how suspicious and disbelieving the world is of their plight, her patients tend to accuse themselves of manufacturing their own symptoms, and Sam has been no exception. She told him back then what she tells them all, as well as way too many ill-informed colleagues and confused students: that an alter isn't a snapshot of the host at one exact age -- it's more often than not an amalgamation of countless variants, like coping skills and unique trauma responses and specific, compartmentalized memories. 

"A two year old alter isn't simply a copy of you at two," she told Sam, hating how anxious her words seemed to make him. "He absolutely might have access to parts of your… well, your knowledge, or isolated abilities that you acquired much later in life. Anything that’s useful to protect you, all of you, and doesn't subject that alter to memories they can't handle." She told him that she'd seen that before, over and over again. 

“It’s part of why people have such a hard time believing that DID isn’t a rare phenomenon,” she said, watching Sam shake his head slowly, his eyes avoiding hers. “The average person assumes that a child alter -- sorry, child other, I know you call them others, right -- would be easy to spot, that they would give themselves away like a kid trying to pass for an adult would. But that's not always true, is it? Many of them are really, really good at laying low. Especially with people like you, who have a kind of shared awareness most of the time. This is a complicated disorder, Sam, and it has a wide spectrum. Please don’t write off what you’re dealing with just because it’s not what you were taught to expect. It just isn't fair.”

That conversation seemed to bring him some relief, but it didn't last. Sam is frustratingly quick to interpret any seeming inconsistencies as proof that his condition isn't real. For all of his and her efforts, he still recedes into that denial way too often, which she isn’t surprised by: it takes time, often years, to chip away at that particular rock. She’s accepted -- okay, fine, almost accepted -- the fact that no amount of talking will speed up that process, certainly not in the time they’ve been given. But knowing that doesn’t make it any easier. So many of her patients seem to have been robbed of their ability to safely make it past square one -- _name your problem --_ and it pains her to watch them working hard to heal without that basis, to clean and bandage a wound whose very existence they can’t help but continuously question. Doesn't help that so few of them can afford to be open about it to people in their lives, either.

She sighs as she presses the button on the coffee maker _. This is the work. Part of the work._

"So what are _you_ so mopey about? Someone break the machine again?"

She raises her eyes to see Matt studying her face, looking worried despite his teasing tone. The guy can't for the life of him express sincere interest, she knows that by now, and this is the closest he gets to actually betraying concern. She doesn't have the energy for workplace banter, though, and she responds honestly this time. 

"No, I'm just thinking about how sometimes - - you know, sometimes it's the patients with the most obvious wounds that are the toughest to convince that they're not making up their issues. Trauma patients, especially. It's just… it's so goddamn frustrating, some days."

Surprisingly, Matt just nods. Maybe he doesn't quite have the energy today, either. "Almost always a struggle for them, yeah. And it's extra bad when there's memory loss, too. You're thinking about stuff like DID, right? I know you've been working with dissociative patients a lot here."

She can't help but sigh again. "Yeah. I mean, people doubt what they _do_ remember too, but when they don't -- it’s just - - sometimes it feels like I'm fighting impossible odds, you know? I don't just mean traumatic memories that get buried, I mean even the amnesia some of these folks deal with on a daily basis, in the here and now. It's like - - I tell them what we all see, they can get feedback from other patients in here about what happened that they don't remember, the alters, the flashbacks. But they'll still tell me that they must somehow be making it all up. That nothing severe enough happened to them to cause all of that _;_ that even if it did, they shouldn’t be reacting that badly; that they're just convincing themselves about having parts. Denial feeding denial."

She looks back down at her cup. Thinks for a moment. "Do you know one of Sam Wesson's alters keeps telling me that Sam can't be trusted? Like, almost every time he's in control. He says Sam is 'too suggestible', and that there's nothing really wrong with him. That he's pretty much the sole cause of his own problems. The guy actually says that to me as he's standing there, an alter. And he believes it, too."

Matt raises an eyebrow. "That's - - man. You're talking about Jay, right? Yeah, that dude is a piece of work, I've had a few run-ins with him. So how does he explain his own existence, then, if he thinks Sam is just... dreaming them all up?"

"See, that's the thing. He has this circular logic that you can't really touch. I ask Jay if that means he's a fabrication, if he thinks he doesn't really exist, and he laughs at me. It’s clear to him that he’s real. But when I point out that his existence means Sam isn't lying, he just shrugs and changes the subject. Every time."

Matt frowns for a moment before he says, "okay, so that sucks, but it sort of sounds like Jay needs to believe what works for him. And he hates Sam, right -- he always has something nasty to say about him."

"Oh, yeah. He might be what we call a 'persecutor alter'. I'm not entirely sure yet, it's complicated."

Matt nods, filling his own cup with fresh coffee and looking disapprovingly at the full kitchenette sink. "Well, if he hates Sam then he _would_ call him a liar, wouldn't he. Plus, like I was saying, maybe he needs to believe that it’s all in Sam’s head in order to ignore what happened to them all. Hard to walk around like you’re untouchable if you know what Sam knows. Maybe Jay doesn't want to believe what he knows made him necessary. Maybe he really _doesn't_ know. Can't know." He shrugs. "Like you said, it's complicated with systems, always."

Kate thinks about that as she makes her way back to the nurses station. She’s always focused on Jay’s hatred of Sam, on his attacks on the body that they share, but Jay is also the one who steps up when there’s a confrontation that Sam can’t handle; he's the one who takes the wheel in a heartbeat whenever Sam is in physical distress, too. She’s seen the switch so many times, the way pain and panic drain away as he takes charge, allowing Sam some rare respite. Jay is not just Sam’s persecutor -- at times he’s his protector, too. And Matt is probably right about his denial being a tool of survival. If denial is part of what allows him to keep Sam alive, her insistence on poking holes in it might not be the best way to go. 

_Well then WHAT?_

The kid occupying Sam’s familiar frame has relegated himself to the far end of the checkup bed back in the nurses station, and he’s sitting there cross legged, hands clasped around his ankles and head bowed down, a green hospital blanket draped around his shoulders like a sad cape. She assumes it was Megan who felt the need to cover him, and she isn’t surprised at the gesture. It’s not just because a few of Sam’s child alters seem to always be cold, unlike Sam himself. She’s found that the staff tends to be fiercely protective when dealing with a Little -- even the ones among her colleagues who seem to distance themselves from patients’ other alters. In that sense, Sam isn’t unique; she's seen this happen with practically all of their DID patients. She supposes it’s second nature to most people -- especially those who work here -- to want to keep already-wounded children from suffering more pain. No matter what form those children take.

“Hey,” she says softly, trying not to startle him. The man _(the boy)_ on the bed flinches, raises his head, and his eyes are so wide with fear and instantly apologetic that her stomach drops. _I'm safe, hey, I promise - -_

"It's alright, just me," she says. "And you're allowed in here. Everything's okay."

He nods, relieved, and sags back against the wall. Considers something for a moment. "Kate," he says, beaming with pride at his ability to remember her name this time.

She smiles, surprised by how fast the change in his mood is, even though she remembers children's ever-shifting focus. "That's me."

He looks down at his hands, at his -- Sam's -- long legs, and it's like his light dims. Like he's just realized something. "We don't - - um, my name. How come I don't have one?"

Kate considers her response, considers how much she can actually tell this part of Sam's system without causing even more distress. It's not like she can start a discussion with a child about how well-defined alters can be for different people, about varying levels of separation. Or about all the other reasons why some alters simply remain nameless. "Well, maybe you could all decide on a name for you, if you feel like it. What do you think?"

The kid looks skeptical. "We can? We can pick whatever name we want?" He frowns, fingers digging into the soles of his feet. _Worried. He's always so worried._ "How?"

Kate smiles at him again. "Well, you don't have to, but if not having a name bothers you, you can check. See if you can listen inside. If there's a name that comes up."

The suggestion is met with a helpless shrug, but then Sam's eyes go dull for a long moment. She knows what that means -- the boy who’s at the wheel is receding into the inner space that all of Sam's alters seem to share, whether they know it or not. Some amorphous place that's disconnected from the outside world, but still co-exists with it. He's checking, listening like she suggested. 

She backs away for a bit, drinking her coffee and chatting with Megan. Gives him his space for now. 

This is, in fact, how they found out Jay's name. He’d been complaining about not having one, about hating the way other patients and staff members kept referring to him as _Sam_ because they had nothing else to go with. 

She asked him then to think about it, to listen, even when he's not out in the front of the system’s consciousness. Jay rolled his eyes at the idea, told her that it was all just Sam's made-up reality, and that he didn't know what the hell she meant by 'listen'. But the next day, Sam approached her in the hall to ask for a quick talk. 

"I know his name," he said after he followed her to her office and watched her close the door. "The guy who takes over and hurts the body sometimes. I mean, it just popped up. It didn't - - it didn't feel like I came up with it, it was suddenly just _there._ "

"What do you mean?" She knew exactly what he meant, had seen it before, but she wanted to allow him to phrase it for himself.

Sam looked uneasy. "Well, it was like - - you know how words from a song, or from some historical speech you had to learn by heart for school, can get stuck in your head sometimes? And they're not _your_ words, but your brain keeps reading them out loud to itself, sort of? Even if you hate the song, or whatever it is that's looping around in there."

"Oh, yeah. Like an earworm, right?"

"Yeah, I guess. So I just… got that. Without the repetition. Like a thought that wasn't really mine, but still came from the inside. I suddenly had 'my name is Jay' echoing in my brain. Just… out of nowhere. And I knew who was saying it."

"It's not _that_ out of nowhere," she said. "We asked him to tell you his name, right? Remember? In our session yesterday."

Sam gasped. "Crap, I completely forgot about that. Wow, that is _weird._ Doesn't happen that often, this feeling like… like a thought in my head is 100% not mine."

"But it does happen?"

"Yeah. I just always assumed that's how thinking worked. I mean, I still do, kind of. Maybe I'm just - - everyone has their inner voices, right? People always talk about their 'inner child', or about their 'inner critic'. That sort of thing."

She nodded, searching for the exact words. "Yeah, that's true. The difference is that it doesn't feel foreign. I mean, you might not like certain thoughts, you might attribute them to certain parts of your history or a tendency that you have a hard time shaking, like… like self-loathing, or like envy, or other things we carry that we don't necessarily like or want. But they'll still be ours. Is that how it feels when this thing happens?"

Sam's face darkened. "No, not even close." 

"Do you know why _that_ name? Why Jay? Does it mean anything to you?"

Sam shook his head, frustrated. "Nothing. Never had a friend named Jay, or an enemy for that matter, never watched a movie or read a book that had a meaningful character named Jay, not that I remember. I have zero clue about why he picked that."

It took a surprisingly short time for Sam to get used to Jay's newly revealed name, though, like it was a puzzle piece that just fit into place. She wonders now if it will go as smoothly with the kid's name. Sam's Littles are generally less communicative, both with him and with everyone else; they do cooperate, the way a scared child might when surrounded by adults, but they don't all have the tools to express themselves. She'll have to wait and see.

The answer comes faster than she expected. Megan waits until they're alone again in the nurses station to point her attention to the drawings that Sam's alter left behind, along with Sam's shoes, as he was escorted back to his room. "Take a look at this. He signed one."

The crooked, shaky letters at the bottom of the page, below a house colored soot-black and an orange, laughing sun, read _Evan._

Evan it is, then.

*


	3. Chapter 3

**Summary for the Chapter:**

> **See the fic summary for trigger warnings and disclaimer.**

It’s a while before she sees Sam again. She has Tuesday off this week, and Evan is still very much the one in front when she leaves on Monday evening, much later than she’s supposed to. She knows better than to expect those extra hours to be considered overtime, not under the new rules since budget cuts; she also knows it’s not smart or healthy to hang around long after her shift is over, certainly not on a semi-regular basis. Most of her colleagues (well, maybe not Megan) seem to attribute this habit to an overdeveloped sense of professional duty, and well, she lets them. She can even tell herself half the time that they’re right, because they partly are. The discrepancy between the time they're paid for and the time it actually takes to tie the day's countless loose ends; the pit in your stomach that you can’t quite leave behind sometimes. This place does have its way of holding on to you, and she often feels like management is counting on that to keep them working the hours that they do. It’s all true.   
  
But that's not why she stays, not entirely.

It's been hard, and getting harder, to come home. Been this way for a few years now. She can't quite put her finger on it. No easy answer to this one; she and Kiran have a good balance going these days, the place they’re renting is actually fine, she has a small group of friends she can go out with or invite over. Life isn’t overtly _miserable_ , not like when she was in school. 

And still.

The apartment is all hers tonight; Kiran is gone for the week, which accounts for the eerie silence that feels like it's pressing against the door from the other side, waiting for her to come in. She suddenly misses her roommate's constant background noise, which usually annoys the hell out of her. She rolls her eyes at herself as she turns the key in the lock and pushes in, dropping her bag and getting out of her shoes before she even fully closes the door. _Just make the best of this, come on._

Something fuzzy drapes itself over her ankle in the dark, and she stumbles around in a state of utter panic for a good 2-3 seconds before the logical part of her brain comes back online.

“Shit, Angus! Every time!”

The cat meows in a way that she's pretty sure means _screw you,_ _where's the other one,_ and hops up on a nearby chair to stare at her expectantly. She takes a breath. _Okay, okay, right._

"Still just me," she says. "Got you some treats, though." 

She leans against the wall as she waits for her pulse to go down. Makes a mental note to check why the night light that usually turns on automatically for the cat is off. They probably need to get new batteries. "I’m sorry, catto. Hey, your papa’s gonna be back in no time, okay? Promise."

Angus stretches up to rub the side of his head against her hand. _Look at that. Must have been a long day in here, too._ “See, you can be sweet,” she says, and the cat meows again, softer and distracted this time.   
  
She stands by the chair for a while, her fingers running through Angus' black fur, her eyes closed and her back flat and aching against the wall. Tries to let the day, the hospital, the weight of sadness slip away. 

That keeps getting harder, too.

*

She’ll later learn from the ward’s shift logs that Sam came back, so to speak, a couple of hours after she left; that he had an uneventful night, that he was quiet and withdrawn through most of Tuesday. But it’s Jay that she meets when she comes in on Wednesday morning. He smiles at her as she passes by the nurses station, and she slows down at the sight of him, her heart plummeting. It’s not the fresh wounds on his arms, it’s his face that gets her. The fact that he fucking _grins._

Megan doesn’t look up, busy tending to the latest damage that Sam’s body has apparently sustained again (except it’s _not just_ **_Sam’s_** _,_ Kate reminds herself). The nurse’s intense focus probably has to do with her not wanting to make eye contact with Jay, to be honest, and Kate can’t blame her for that right now. The guy’s energy is unsettling enough when he’s just sitting there; dealing with him right after he’s attacked the tormented body he's cohabitating in is beyond alarming. Seeing how damn content he is, almost smug about it. Seeing that glowing smile.

And she knows; she knows that it’s part of what helps Jay keep the door closed. That’s how Sam refers to it. The fact that he’s co-conscious -- aware but incapacitated -- during some of the switches, which isn’t always the case with DID, allows Sam to remember a fair bit about what goes on when Jay is in charge. It means that she sometimes gets some insight into why Jay does the things he does, information that Jay would never volunteer. That he resents Sam for disclosing, most likely. 

This is why she knows, and reminds herself, that the cold grin is often Jay drowning out Sam’s horror and embarrassment before they bubble up to the surface and risk his control. This is Jay bolting the gates: _stay away, go cry yourself to sleep. I’m not done here._

Sam has told her this on more than one occasion, when they spoke about how it is for him, being trapped in that proverbial back seat and watching Jay drive off the edge of another cliff. Kate can tell that the alter really _does_ find people’s dismay at his self injury absurd, even laughable, which is definitely alarming to her. But she remembers how much pain lies trapped and inaccessible, just one layer beneath the calm, shallow pool where Jay swims.

Still, she can’t help but wince as she passes by the nurses station; something about the expression on Jay’s face, as he lifts his head to meet her eyes through the glass. It’s so foreign, so un-Sam, and somewhere in it is an eerie sort of… joy, almost, at the damage he’s caused. _That_ part Sam rarely talks about, maybe isn’t present for. And it’s even harder to take. 

She’s heard Jay talk more than once about his plans for the body, about how much he’s set on destroying it, and she could deal with how cold he seemed as he was describing it. Encountering that kind of emotional detachment is just part of the work with trauma survivors -- she’s accustomed to hearing some of the worst things being said in the most offhand way imaginable. She knows the mechanism that makes that so necessary, accepts its value to people’s survival. God knows she’s prone to using it, too. But it’s when Jay lights up the way he does now, when he seems not just nonchalant, but truly delighted by the damage -- or talks about these plans and seems _expectant --_ that she wonders who it was in Sam's early life that taught him such sadism. 

She has her guesses. She doesn't think she'll ever get to confirm or disprove any of them, though. Not in the time they have left. In fact, she worries about breaking the seal around that knowledge unintentionally and then leaving Sam to fend for himself. _They don’t talk about that in school,_ she told Kiran one night, as they sat on the living room floor with a bottle of Tequila that she needed way too much. She got the worst kind of phone call that morning. _They don’t talk about how part of the job is refusing to touch wounds that people are ready to open, begging to treat, just because you know your patient will be thrown out halfway through the process, raw and exposed._

_They don’t talk about how to deal when those wounds open on their own anyway, either, and you still have to send that reeling, shell shocked person on their way._

_Or about what to do when a 24 year old who’s survived hell dies two days after discharge._

She needs no reminders about the balancing act that she has to perform with Sam, one that has to do with finance more than healing. No one here does. 

The door to the nurses station is open now that there's a patient inside, but she still knocks to alert Megan as she steps in. “What happened?”

Jay snores derisively, his eyes leaving hers to observe the damage. “Not much. I got interrupted.”

Megan shakes her head before she finally looks up. “We just got done suturing him. He sneaked a craft knife out of occupational therapy and did this in the bathroom again -- nicked a minor artery, too. It was a mess.”

Kate feels the anger bubbling up in her chest like acid as Jay shrugs; she knows just what that shrug means, can practically hear him think it. _Better luck next time._

“Really, Jay?” Her voice is sharp, cold, and it occurs to her that she probably sounds a lot _like_ Jay at the moment, but she doesn’t care. “Aren’t we past that by now? Sam has been trying so hard to get better in here. I know you don’t approve, I know you think it’s pointless, but you’re really setting all of you guys back every time you do this.”

Jay‘s gaze finds the window, studying the view outside like he’s cataloguing every piece of scenery as he says, “I think we both know this is over.” 

“What are you - - what?”

“You’re letting us go, remember? Big douche in charge doesn’t like the hard cases. How long do we get before you kick Sam’s ass out of here? A week? Two?” His voice is perfectly calm, icy and serene, and Kate can’t help but imagine Sam buried under that impenetrable blanket of numbness, gasping for air. 

"What makes you say that?" She wonders if he or Sam overheard something, though she doubts that's the case. Sam and his other alters possess that uncanny ability to catch the tiniest hints, the smallest shifts in other people's mood and body language, that she keeps encountering among so many of her patients who grew up in unsafe circumstances. Just last week, while she was talking to Jim in Occupational, she watched Sam reach over and cover a sharp piece of wood with his hand just in time to prevent Emily, a newly-admitted patient, from taking it. The young woman looked up at Sam, visibly rattled, as he said, "don't." 

"How did you - - what?"

Sam just smiled at her, pained and apologetic. "I know the look. Just don't."

Emily told her later that day, in therapy, that she'd been discreetly searching that room for something sharp the entire hour before Sam foiled her plan. "I don't know how he knew I wanted to hurt myself. I didn’t say a **word**. Not one word. It's just freaky."

 _Not that freaky,_ Kate thought then, thinks now. A childhood spent playing defense, watching for clues and telltale signs of an unpredictable adult's next eruption, will prime you for just that kind of constant vigilance. Add to that the fact that Sam knows a thing or two about self-injury, and it isn’t hard to believe that he’d be the first in the room to pick up on another person’s gaze consistently lingering over sharp objects. Kate thinks that she wouldn’t even call it intuition, just impossibly high alertness. And she knows it comes at a price.

She has to assume that Sam and all his parts have somehow, similarly, figured out that they're about to be abandoned by a health system that only few of them agreed to trust. Staff members who look away or give shifty answers can be enough of a clue sometimes; she wonders if knowing that Sam’s days here are numbered played more of a part in Jay's self-injury today than whatever had been said during visitations. If Sam’s level of despair is rising because he feels hopeless, trapped in his anguish, then Jay _would_ take his rage out on the body that he feels equally imprisoned in.

No use lying, not at this point, but she tries to phrase it in a way that won't make things worse. "Listen, Jay, you're not wrong about the fact that not everyone up the ladder shares my views on how to treat - - what you guys are dealing with. But I'm doing my best to have you stay here the longest time possible, okay? And what you just did really doesn't help your cause. I know this isn't the first time this happened in here, but there's a LOT at stake right now."

Doesn't sit well with her to tell him that, but this is nothing new. She’s both conducted and witnessed her share of warning talks with inpatients about self-injury. It feels shitty, telling people that they might lose their place over behaviors that often stem from the very thing that brought them here. Lessons in self-destruction that were learned early on require time and patience to undo. They don’t necessarily _have_ that time, especially not with patients whose injuries are risky like the kind Jay goes for; she isn’t clueless enough to be unaware of THAT. And still, prevention through mere intimidation feels... wrong. She’s seen how taking away a person's only pressure valve without offering an alternative can backfire.

Adams, of course, has a different view on the matter; he likes to define the threat of terminating care as “teaching patients accountability”, though she’s pretty sure his main concern is avoiding his own. The potential legal repercussions of a patient suffering serious physical harm under his roof are more likely to keep the guy up at night than what happens to that patient once they’re kicked out. And she’s seen him make good on that threat, too. Still wonders about a couple of those people.

But it's not just Adams, if she's honest. This is an undeniable truth that she's had to work with since day one: the mental health system's tolerance to self-destruction is finite, it's always limited. And the places it tends to send you if you spiral down too far are almost never equipped to deal with complex dissociative disorders. She doesn't want to see Sam go down that road, can only imagine what he'll have to endure in the locked ward if he switches in there. _Bad idea._

And a locked ward doesn't seem like an unlikely outcome, right now: the head of the department may want Sam out of here, but he could just as easily have him transferred to a different, worse hospital to make him someone else's problem, now that releasing him while still freshly wounded might look bad. _Shit, shit, shit._

Jay is watching her, his smile fading a bit. He shrugs. "Looks like a done deal from where I'm sitting, doc. You were there when that Adams guy spoke to Sam last week, right? You saw. That asshole thinks Sam is just taking up space. No way is he going to let us stay."

Kate doesn't quite know how to respond to that assertion, though Megan's hint of a crooked smile tells her she shares Jay's opinion of Adams' assholery. She’s half tempted to just drop the pretense of collegial solidarity -- God knows the man doesn't deserve it. 

She still weighs her words carefully. "Look, I get why you - - why you say that. I did sit in on that conversation between them, and I do think it was handled badly. I told Dr. Adams that, too."

Jay chuckles, moving his arm and causing Megan to hiss an annoyed "stay still!" as he pulls on the fresh stitches that she's almost done cleaning. He doesn't seem to notice. "Guess you're in trouble with the boss too, then."

Kate swallows a nervous laugh that she wasn’t quite ready for. “Nah, I’ll be okay. He has bigger fish to fry.” She looks down at the bandage that Megan is now beginning to wrap around Jay’s arm, instantly losing all traces of humor at the sight of the wounds that disappear beneath the white gauze. “Dammit, Jay, you really did a number on yourself this time.” 

She knows what Jay would probably say to this -- _not on myself, on the body, learn the difference --_ and she doesn’t give him the chance. “How are you feeling right now? Any dizziness or palpitations? Trouble catching your breath?”

Jay shakes his head, frowning at the question like it’s preposterous. “It’s not that bad, really. Didn’t lose _that_ much blood. We probably won’t even be anemic this time. You really need to lighten up about this sort of thing.”

“Lighten—“ she has to close her eyes and take a breath, remind herself not to snap at him. Not to say, _for fuck’s sake, you can’t possibly think this is okay, how would you - -_

“Sam is going to take this hard when he comes back,” she says instead. “You know that, right? Or is that why you did this, to upset him? To punish him for something?”

Jay’s grin is wolfish. “No, that’s just a bonus." He looks around, shifts in his chair like he's starting to lose patience. "It's funny, though. Dude is such a fragile little snowflake.”

She knows not to visibly flinch at his disgust with Sam. “Why did you do this, then? Why today?”

Jay shrugs again, pulls his arm out of Megan’s grip and studies the bandages, not bothering to look at the nurse as she makes another sound of protest. He stands up as he says, “it’s fine, I'm good. I’m gonna go out for a smoke.” 

Jay keeps forgetting that Sam threw away his cigarettes, or maybe he’s just that sure that he can charm one out of whoever he meets outside. Kate wonders if he really isn’t aware of how uneasy he makes people, even when he feigns friendliness. He seems well aware of the fact that he resides in a body that many people consider attractive, seems to count on his good looks despite his lack of emotional connection to what he sees as a random shell; but his low-key-ominous, cold energy is enough to drive away even interested strangers much faster than he appears to expect. Or remember. It's not something she can point out to him at the moment, though.

Regardless, letting him out right after that demonstration of his self-destructive abilities wouldn't be wise, anyway. They don't have the kind of manpower that could allow a staff member to accompany a patient down to the yard to keep an eye on him, so patients who aren't relatively stable rarely get to enjoy the greenery that the hospital is so proud of. Unless they have visitors. Sam took his visits outside for a reason; most patients’ friends and families are itching to get out of here pretty much from the second they step into the ward, so the garden is a popular destination during visiting hours.

Which makes her think about Cas again. About whether or not something was said during his and Sam's time outside, a couple of days ago, that might have shaken things up.

"You can't go out on your own right now, Jay, you know that. You're welcome to sit in the lobby if you don't want to go back to your room yet." 

She isn't surprised by the eye roll that the offer is met with, or by Jay's dry "thanks a lot." She does decide to press the issue of what caused all of this, though.

"Sam went out to the garden with that guy Castiel -- Cas -- when he was visiting, right? You remember what they talked about?"

Jay frowns. "Not really." He looks troubled by his inability to retrieve the information; she's noticed a while ago that he seems to retain most of what happens to Sam, like he's always in the background, keeping watch more than the other alters. "They all do," Sam once told her, "they're all watching. The kids just forget more."

She waits patiently while Jay searches his memory; she watches him struggle with details that won't come easily. Sam's mind works like quicksand sometimes, holding on and refusing to release even the most mundane and prosaic memories when there's something else that he needs to forget. Like a blanket that covers everything, undiscerning in what it keeps from the light. 

"We were in the garden. We were in the garden, and - - " Jay suddenly looks confused, unsure. She knows what will come next, knows it the moment he starts repeating himself, but she still tries to help him focus.

"Did you sit down somewhere to talk, or did you walk around?"

"We sat on that stone bench in the corner." Jay seems almost comically surprised at the piece of information, somehow. “Umm, we - - " his eyes go vacant for a few seconds before he blinks and shakes his head. "Nope."

Kate tries a different angle. "What's going on with Cas? Did he tell you about anything that's happening in _his_ life?"

Jay nods, pushing the heel of his palm against his right eye like it hurts to think. "He's been tired. He looked sort of down, and Sam asked him what was up with that, and… oh, Cas told him - - turns out he's been trying to - - to find Dean again. I don’t know, he had a lead or something." 

_So the brother really might be alive. Good._ Sam’s pain is deep-rooted and pervasive as it is, more than enough to shoulder without adding grief over a sibling. And also, Dean is at the very least a potential source of support and stability when Sam is released. If they do find him, that is. If he's not in trouble himself. She gets the feeling that the older brother didn't escape his own childhood unscathed.

She tries to chase the worry out of her voice as she says,"so he and Sam might actually get reunited. That's good news, right?"

Jay shakes his head again. "No, the trail went cold. Cas said something… he said something about Dean not wanting to be found."

 _Shit. Just what Sam needed right now._ "Oh? Any idea why?"

Jay shrugs, then closes his eyes as he says, voice flat, "no. Dean would never leave Sam like that, the guy is too much of a big brother. Plus he knows Sam’s a mess. If he's hiding, there has to be a reason. But Cas - - Cas doesn't have a clue what it could be. And we don't know either."

She notes to herself that he's doing the first person plural thing again, which probably means that he's distracted or not doing well. It isn't unusual for some of her patients with DID to occasionally refer to themselves as "we"; but Jay rarely does. 

“Sam is close right now, right?”

Jay opens his eyes to look at her, surprised. “What?”

“You’re feeling Sam. Am I right? He’s resurfacing? I can tell you’re starting to… you’re looking like you’re about to go.”

Jay frowns, but the expression doesn’t last, and as she watches his face smoothing out and his eyes losing their sharp focus, she knows she’s right. “That’s okay, let him come back. I really need to talk to him, okay? Let him front for a while." It took her a while to start using the word _front_ the way people in the ward do, to describe an alter taking the wheel, but it comes out naturally now. She isn't surprised as Jay frowns at her suggestion, never quick to surrender control. 

"You and I can talk again later," she adds, though she knows it won’t help reassure him -- it’s not the joy of interaction with her that’s making him reluctant to leave.

Jay blinks again. “I’m not - - he shouldn’t be here right now. He’s too -- he’ll just, he’ll - - "

Kate nods. “I know you don’t trust Sam to be able to handle what you did to the body, or what’s going on in general, but he has us. It’s better if he comes back now, while I’m here to talk to him, than if it happens when you’re alone in your room. Or in bed at night.”

Jay doesn’t respond to that, just stares at the wall for a while. Finally he brings his hands up to his face to cover his eyes, the tips of his fingers twitching ever so slightly against his forehead. “Yeah, okay. I can’t bring him out, though.”

“I know. Just breathe and try to relax, and we’ll go from there.”

She waits. Watches the tall man sway almost imperceptibly where he stands, like the body he and the others share is a vehicle struggling to stay in its lane while there’s a scuffle inside over the wheel. This is a bad day; Sam's switches are usually more gradual, practically invisible unless you’re watching for them. She wonders if she's just getting an outside glimpse of what they're like for _him_.

If she had to explain how she can tell when it’s Sam standing there, and no longer Jay, she'd need a minute. Something in his posture, maybe; Jay stands tall, stretches to his full height, unconcerned by whether or not people find him intimidating. Probably considers it a bonus. Sam seems to do his best to shrink down to a height that won't make others uncomfortable, always lowering his head and slumping a bit. It's a mild change, one that took her a while to notice, but it's become a tell that she recognizes instinctively, now.

"You here yet, Sam?"

The man nods slowly, like he isn't quite sure. "Mmmm. Uh, what - - "

He lets his hands drop to his lap, looks around like he's trying to ground himself. They've worked on this: _take notice of what's in the room, keep your eyes moving, feel your feet on the floor. Get back in your body, back in sync with your surroundings._

Sam is doing just that when his eyes meet hers. He smiles faintly, and it's all Sam this time, nothing like Jay's grin. Strange how different the same face can look doing the same thing. Sam's smile is a mix of careful friendliness and all the weight of decades-long pain, and always -- _always_ \-- a hint of apology. That part makes her sad every time. Jay's smile is more like a polite, socially acceptable, but very intentional, bearing of teeth.

Sam's smile doesn’t last, though. His face falls as he says, sheepishly, "Hi. Sorry. I was - - Jay kept me in the back. I mean, **_he_ ** didn’t, I just was. And I - - I saw." 

He looks at Megan, then down at his bandaged arm, flinching at the sight of the layers of white gauze."Really sorry. I hate that you had to deal with that." 

Kate bites her lip as she sees the nurse's eyes go wide. No matter how aware the staff is of Sam's condition, most of them are still caught off guard when they're face to face with a switch. 

Megan clears her throat. "So you remember? You know what Jay did?"

Sam nods, his eyes darkening. "Yeah. It's sort of fuzzy, but yeah, I remember him doing it. And - - and after." 

Kate watches as Sam's breath hitches with a sudden realization. "Wait, someone caught him, right? I remember a door opening and someone yelling. Shit, tell me it wasn't one of -- who was it?"

Kate sighs. "Not another patient, if that's what you're thinking. It was Trevor."

Trevor is one of the ward's maintenance workers, a quietly friendly guy who never fails to ask the patients about their day and tell them about his. Sam's eyes fill with tears.

"Oh." 

He bites his lip, takes a moment to compose himself before he can speak again. "Did - - is he okay? I know Trevor hates blood. He said something about that once."

Megan doesn't meet his eyes as she says, "well, he does work in a hospital. He probably has a strong stomach." She sneaks a glance at Kate.

They were both in the hall when it happened, and they both remember Trevor's face. The way he tripped back over the mop; the way he looked as he sat in the staff room trying to catch his breath, while Jay was being taken to the nurses station. Megan is well aware that no amount of hospital work could prepare anyone for opening a random bathroom door and seeing _that_. 

_Why would he do something like that to himself,_ Trevor said over an untouched glass of cold water that someone got for him, because that’s what you do, apparently. _I don’t get it. Why would anyone_ **_want_ ** _that?_ And Kate isn’t sure that she could answer that question, even if the rules of confidentiality didn’t exist. 

_You can't just shield Sam from the consequences here,_ she thinks, and forces herself to look him in the eye as she says, "yeah, Trevor took it pretty hard. Not just because it was shocking to see, which it was. I think mainly because he cares about you." She's seen the guy talk to at least one of Sam's younger alters, too, remembers how kind and patient he was with the kid.

Sam nods, his face pale and haunted. "He does, he’s a good guy. I should probably talk to him. Tell him I'm sorry, tell him it's not as bad as it looked."

Megan glares at him. "Not as bad? Sam, it was a horror show."

Kate places a hand on her arm as Sam visibly recoils at the sound of the words. _Watch it._ "Okay, okay. Listen, Sam - - hey, sit down for me, will you?"

Sam doesn't argue, flopping back down on the chair that Jay was occupying so casually just a minute ago.

“Look, I obviously can't make you see that incident the way it looked from our perspective, but I promise you this has not been a good day, for you _or_ for this ward. Jay certainly didn't think it was a big deal -- Trevor said he told him to 'quit overreacting'. Didn’t occur to him to stop what he was doing, either, while he was saying that.” She can sense Megan’s anger spike at the reminder of that particular moment, even though the nurse is staying silent by her side now. “So Trevor was pretty upset about that. Can’t say I blame him."

It's almost visible, the way the memory of that moment slides back into Sam's awareness like a hot needle. Kate almost flinches along with him as she watches his mind retrieve the painful information from whatever inaccessible drawer it was filed in until now. The process is never easy, and reminding someone of what their brain insists on hiding from them -- when it's even possible to bring it back -- feels counterintuitive, cruel even. But it might be necessary this time, especially since Sam desperately needs to be able to keep better track of his days once he's released. The more he's able to deal with Jay's actions, and the more he remembers about them, the harder it is for the walls of amnesia that maintain the separation to stay impenetrable. 

But that doesn't make it easier to watch Sam's guilt, or his self-disgust. She can't help but sigh as she watches his eyes darken with memory. Sam looks devastated, and then not even that -- he looks drained. He nods wordlessly, staring down at the floor for a long moment before he finally says, his voice small, "I'm so sorry."

Kate nods, too. "I know. I know you are. Why don't you go rest a bit? Jay wanted to go outside, but I told him that wasn’t such a good idea."

Sam blinks at her, eyelashes damp and gaze unfocused, already too close to another switch. Shame tends to do that. "Out- - outside?"

"Yeah. He wanted to have a smoke."

"Oh." There's that look again, like a band-aid being ripped off as he suddenly remembers another moment that he wasn't quite awake for. 

Sam struggles to get up, and both she and Megan instinctively reach out to steady him as he almost loses his balance. He leans against the back of the chair, his face grey. "I'm okay," he says, "just - - just stood up too fast." 

Kate wonders if it's the blood loss, if it was that bad this time. They caught it fast, but still. They'll probably want to check his hemoglobin levels, if nothing else. Just to make sure. They've been doing that anyway, since the beginning, in case there were any new injuries that someone in Sam's system managed to hide. She trusts Sam to let her know if he ever comes back to find any new damage caused by Jay, but not everyone in the staff shares her confidence about that. Which Sam is well aware of, too. It hasn’t been an easy road.

“Better?” Megan asks, studying Sam’s face as he lets go of the chair and starts slowly making his way out of the nurses station. 

Sam does his best to smile, unable to look either of them in the eye. "Yeah," he says. "Thank you. Sorry."

There are only a couple of people in the hall, Amy and David, both of them fellow patients; Sam pulls on his sleeves before they can see his bandaged arms. Kate isn't sure if he does so to avoid upsetting anyone -- he's not the only person in the ward dealing with that sort of thing-- or simply because he's embarrassed. Probably both.

"I'm guessing we'd have a hard time getting Jay to do _that_ ," Megan says behind her. Apparently she noticed, too.

Kate hates that she's right about that. Jay isn't malicious, not towards other people at least -- his aggression is mostly turned inward, at Sam and at the body he shares with him, unless he perceives an outside threat. Other people aren't really something he seems to consider, except to evaluate whether or not they pose a problem. Kate figures either he's too busy with inner battles, or -- and she suspects this is more likely -- being as emotionally disengaged as Jay is takes all available resources, even if he doesn't actually _feel_ the effort. The mere fact that Sam comes back so exhausted every time Jay takes the wheel makes that clear. Either way, the thoughts and feelings of people around him wouldn't be a top priority for Jay.

And so she's pretty sure that, while he’d never mess with the staff or other patients by intentionally subjecting them to Sam's bandaged arms, Jay wouldn't bother to hide anything for their benefit. He certainly wouldn’t roll his sleeves down like that, wouldn’t even think to.

His words from earlier in the week echo in her mind. _Just the random pile of meat you’re stuck with._ Wasn’t that what he said? _As long as it’s working okay._

She watches as the casual conversation in the hallway comes to a halt; Sam keeps his eyes down, doesn't say anything, just walks to his room and slips quietly inside. Amy and David exchange glances. Word travels fast around here, and they’re most likely aware that _something_ went down.

 _We're going to need to address this with everyone at some point today,_ she thinks, _tomorrow morning at the latest._

It's going to be rough. She wonders how much people already know. Mercifully, everyone was in therapy or in group activity when the incident took place -- but even if no one saw, that sort of thing doesn't remain a secret. And shock waves are sure to hit at least some of the patients, like they always do when someone is in severe crisis.

Sam doesn't emerge from his and Luke’s room for the rest of the day. He would usually have to contend with a fair amount of nagging for taking a pass on activities -- staying isolated and in bed is an issue here, there's a constant battle to help drag tired, pained people away from that magnetic pull -- but today the staff is letting it slide. For other patients’ benefit as well as Sam’s, at least until they decide how to address what took place. 

She hopes for Sam's sake that he's getting some actual rest, though she very much doubts that.

They eventually decide to bring up the incident in morning group. She knows Sam won’t get a pass on _that_ ; he’ll have to face people's responses. And though she knows it’s inevitable, she also in no way shares Zach’s optimism that “just seeing how much folks here are upset” will have a preventative effect in the future. The part of Sam that’s adamant on destructiveness as its only course of action, at least when Sam’s despair hits a certain level, has its roots in a much older, much sneakier, less literal injury. 

Sam’s back is turned when she comes in for one last check before she goes home; his part of the room is dark, his reading lamp off. She isn’t convinced that he’s asleep, but when he doesn’t respond to a quiet “Sam?” she leaves him alone.

She completes her rounds and checks in with the rest of her patients, and as she walks out to the parking lot, she resists the urge to head back to her office and just sit there with a giant mug of coffee for the rest of the night, surrounded by papers, instead of going home. _Oh, this is not good._

When her phone lights up and an unexpected contact number pops up on the screen, she is way too grateful for the distraction.

"Hi, Cas."

*


	4. Chapter 4

**Summary for the Chapter:**

> **See the fic summary for trigger warnings and disclaimer.**

Castiel's eyes are a very specific, unusual shade of blue. She hasn't really noticed that until now, but with the morning light shining directly at them through the wide cafeteria windows, it's almost disorienting. Maybe it's just the intensity of his concern.

"I'm glad you called me," she says, digging into her only-slightly-wilted salad. Cas got a cup of coffee and a piece of blueberry pie, which actually doesn't look bad, but he isn't touching it; hasn't even picked up his fork.

"You are?" He seems relieved. "I was worried that - - I wasn’t sure it was appropriate. Especially that late in the evening.”

“I'm glad you did call, it gave us a chance to set this up. And I gave you my number for a reason. I think Sam needs all the help he can get, right now, and you’re a major part of his life. Once he leaves here, you’re his support system.”

Cas nods. He seems saddened by that assertion, and it takes a second before she realizes why. “And Dean,” he says, gaze lowered.

“Sure. Of course. I didn’t mean to leave Dean out. It’s just that he can’t be around at the moment. Right? You guys don’t know where he is yet?”

Cas picks up a saltshaker, studies it like he hopes he’ll find some sort of answer in the angles of the cloudy glass. “No. But he’ll be back.”

Kate watches the man’s face. “You seem sure about that.”

“I am.”

She’d ask him why, but she has a feeling that won’t get her far. “Look,” she says, searching for his eyes and finding that luminous blue just as distracting as before, “I can’t really share much about Sam’s care. The information can only go one way -- you can tell me anything you feel might be helpful, but I can’t return the favor.”

Castiel’s eyes turn hard. “I’m aware of that. That’s not why I called.”

“Okay. Okay, good.” She’s surprised by how guilty his response makes her feel. _Don’t apologize._ “I just had to make sure you knew. I know you ARE family to him, but we’re bound by all sorts of policies here.” She clears her throat, still feeling uncomfortable. “So I assume you wanted to tell me something, then?”

Cas averts his gaze, a spotlight flickering. “I wanted to tell you a little about how things were for Sam before he got here. And about Dean.”

 _Oh._ “That’s great, I’d actually love to hear about him. Can I ask - - I mean, you’ve had my number for a while, right? Since the beginning. What made you reach out about this last night? Not complaining, just wondering.”

Cas sighs. “Sam told me he had a feeling like he was on his way out of here. That the hospital wasn’t going to keep him much longer.”

So it’s not just Jay who’s worried about that. She wonders why Sam hasn’t brought it up during their sessions. 

“It’s… well, it’s under discussion. Yeah, there _is_ a chance they’ll be releasing him sooner rather than later, although I’m trying to prevent that.”

She is unprepared for the urgency in Cass’s voice as he says, “please, try to make them - - try to help him stay. I really think he needs this.”

 _He’s scared. He’s scared for Sam, of course he is._ She reaches out, almost places her hand on the man's arm _(why is he wearing his coat indoors?),_ then pulls back. "Cas _,_ are you worried that something might happen to him if we let him go?"

Cas sighs again. "I am. But that's not the only reason why I think he needs this place. I think he - - I think it's safe for him in other ways, too."

"Like what?"

Cas considers his words for a while before he says, hesitantly, "you - - you've met them, right? His others?"

Sensitive territory. She says nothing. Cas seems to get the hint.

"Right, you can't tell me. That's okay. It was sort of a rhetorical question, I know from Sam that the staff is aware. And from what his roommate said, the other patients know about it, too." He shrugs. "I actually think that's good."

Not something she's ever heard from friends and relatives of her patients who had DID. The usual response tends to land somewhere on the scale between utter disbelief and "okay, but how do we make it stop". Acceptance is… well, it's rare.

"You feel like this is a safe place for Sam to not hide who he is? Is that what you mean?"

Cas nods. "Look, I've seen Sam struggle with this for years. I mean, I guess it was there -- _they_ were there -- long before I met him and Dean. But it took me a really long time to understand what I was seeing. And it wasn't as… as pronounced back then as it is now."

She assumed that had been the case. "Well, I can generally tell you that’s not unusual. I've had some patients who only started externally manifesting their condition late in life, some much later than Sam. It was always there, but it was well hidden. And very low-key even on the inside, in their own awareness, for some of them -- until it wasn't. With enough stressors, or changes in circumstance, that delicate balance can break; some things become less manageable. Defenses that could afford to be hidden become more dominant, take more place, shake things up. I usually see folks when they feel like they can’t hold it all alone anymore, when they’re at the end of their rope and have to ask for help. Those who do. Who can."

Cas gives her another emphatic nod. "Exactly. That's how it was with Sam. He was managing it before Dean was gone. Well, I mean, not always. It just wasn’t happening as often as it does now, and it wasn’t - - it was harder to see than it is now. But there were always times when you could tell it wasn't just Sam in there."

"In what way?" 

Cas thinks for a moment. "Well, for one, there were things he couldn't remember. Entire conversations, gone. Jobs we worked the day before. Stuff like that. And sometimes that was that, he just forgot. But sometimes, maybe the next day, you'd be talking to him and he knew all about it again."

Cas smiles, though his smile is crooked this time. "Took me at least a couple of years to get that I was talking to different parts of him, that they all had their own access to memories. If Jay was there when we worked a job in Oklahoma, he could tell you the color of a picture frame on the wall of the motel where we had stayed. But you’d mention it to Sam, and he had no clue we’d even crossed state lines. Sometimes part of it would come back once Dean and I reminded him, but just bits and pieces, at best. Sometimes it was like he had no idea what we were referring to, as much as he tried to hide it. It was - - it was unsettling, to be honest."

Kate thinks about that blank expression that she knows so well, not just from Sam but from other dissociative patients. Mateo calls it _the Data Missing Look_. "Yeah. That makes sense."

Cas rubs his forehead, sounding tired now. “It was always there in the background, we just didn’t realize what it meant. Dean and I assumed it was stress, or that Sam couldn’t think about some things because he was carrying too much. They both do. Dean went through his share of—“

Cas goes quiet as soon as the words leave his lips, looks like he regrets opening that door. Kate doesn’t push, just says, “right. Yeah. Neither of them had it easy. They’re both dealing with some trauma.”

“I’d say so, yeah.”

“So when did you figure out that it was something more than a memory issue?”

Cas shrugs. “Well, I think we had our suspicions, because it didn’t _feel_ like Sam some of the time. But ‘maybe it’s dissociative identity disorder’ isn’t usually your go-to explanation, is it? No one really considers that, and even when I started to, Dean - - he had a hard time hearing about it.”

“Yeah.” Kate isn’t surprised by that; no one takes a DID diagnosis easily, but family members are often the most resistant. People have a hell of a time re-framing a loved one’s behaviors and emotional difficulties that they’ve explained to themselves, for years, in their own terms. “Has he -- become more accepting of it since then?” 

“Eventually, yes.” Castiel’s eyes wander as he thinks back, looking somehow both sad and nostalgic. “You know, we were sitting in a diner one time, and Jay kind of outed himself."

Well, Jay _would_ be the one to do that, if Sam's system was going to reveal itself to anyone. "How? What did he do?"

"He didn't really do anything. He just said it. Sam -- well, the person we assumed was Sam -- had been acting different all day, and Dean and I sort of ignored that, because that was just the way things were with Sam. You couldn't really ever ask him about that, he just wouldn't remember, after. Or maybe he was embarrassed, maybe he tried to play down what he did remember."

Kate sighs. "Yeah, that happens a lot."

"Anyway, he'd been cold and sort of… bored, all day, pretty antisocial. Which isn't like Sam -- even when he's really upset, he doesn't get like that. Quiet and withdrawn, or angry, sure; but not that sort of distant, not... dismissive. You know?" 

She nods, saying nothing.

"So we were sitting at the table, and I guess Dean said something about how Sam was finally 'eating something real'. I think it was cheeseburger and fries, something like that. Not something I usually saw Sam eat, if he had a choice."

She can't help but smile at the obvious Jay choice of food. "Yeah, sounds about right."

"And that's when he said back to Dean, 'you know you're not talking to Sam, right?' Just like that. He actually rolled his eyes a little, like saying it was stating the obvious. I think Dean almost spit out his coffee."

"I bet.” She can’t begin to imagine how it would feel to hear your sibling utter those words, or anyone you’re close to, really. “And?"

Castiel's eyes avoid hers. "We - - we thought he was po- - well, we were worried."

It almost sounds like he was going to say _possessed._ He wouldn't be the first to talk about it in those terms, but she's glad he stopped short of actually saying the word. There’s a different weight to the metaphor, now that she’s aware that generations of people with DID were among those who suffered through exorcisms as a result of that particular interpretation. 

And also because she remembers Sam's face when a new patient jokingly referred to his switches that way in group.

Now that she sees the way Cas narrowly avoids the term, the tension on his face, she wonders what it is that makes the word so loaded for Sam and his small family. She doubts it’s the social and historical context. No, both men’s reaction betrays a sort of pain that’s more concrete, almost like possession is a real life thing to them rather than imagery. But she can’t imagine that it would be.

There are more urgent things to explore. “So what happened then? I mean, what did Dean say?”

Cas sighs. “He - - well, let’s just say once we both realized Jay was an alter, Dean took it hard.”

“Did Jay tell you his name?”

“No. We didn’t think to ask, or maybe it was too hard to ask. I don’t think he knew back then, either way.”

Kate nods, thinking. “He probably didn’t. When was this?”

“A couple of years ago, give or take.”

“And it wasn’t as… evident as it is now, back then?”

Castiel shakes his head, pensive. “No, not exactly. But I think that’s around the time when it started to gradually get - - stronger, I guess. That’s probably why Jay outed himself like that, things weren’t as controlled anymore. And it was harder for Sam to hide it, anyway; he was losing more time, missing more memories -- new ones, I mean, everyday life -- and he was switching a lot more. We didn’t call it ‘switching’ back then, but we knew when it wasn’t him. It’s like, once you’re aware, you can’t unsee it.”

Oh, she gets that. “And Sam didn’t get any therapy, right?”

“He couldn't. The job took us everywhere, and on a moment’s notice.” Cas meets her eyes as he adds, “and to be honest, I don’t think he felt like he could really talk about his life to outsiders.”

She’s well aware of that, too -- her sessions with Sam are a constant negotiation, like there’s so much he can’t say even about the things that he does remember. She often wonders if the petrified silence some of his younger alters are trapped in has to do with that. Not just with an old fear that seared itself into Sam’s brain early on, but also a ban on sharing certain information. A rule powerful enough to reach all parts of his system. It’s possible to a degree, especially for someone who’s co-conscious a lot of the time.

Still frustrates the hell out of her. She’s tried reassuring Sam that he was safe, no matter what he revealed; that everything was confidential. Sam just smiled at her efforts -- one of those pained smiles that look more like he’s trying not to wince -- and said that it wasn’t himself he was worried about. 

She assumed, at first, that he was protecting a family member. Maybe someone who hurt him back in the day -- people’s loyalties don’t always fade with the realization that they were wronged, no matter how devastating an injury they were dealt. But the more she talked to Sam about this issue, the more she got the feeling that it was her he was guarding. That he didn’t think _she_ could handle whatever reality he had lived through. Or maybe the reality that he would be going back to, once he left the hospital.

She realizes that Cas is watching her, his brow furrowed. “Sorry, I was just - - I was thinking. So did Sam continue to work with Dean and you while this was going on? I imagine it would have affected all of your daily routines.”

“It did. Eventually, Sam started staying behind on some jobs. Not all of them, though. I mean, when Jay was around, there was no talking him out of taking part -- he loves the job. And he's… efficient. Dean knew that. He didn't like it, but he did work with Jay sometimes."

"And the rest of them?"

Cas puts down the saltshaker, pushes it carefully forward with the tip of his finger, like he's involved in a high-stakes game of chess. "Well, it was a bit more challenging with some of the others."

Kate nods. "The younger ones? They get scared, confused?"

"Yes." Castiel doesn't seem to want to discuss it any further. He reaches for his phone. "Can I show you something?"

"Sure."

As he scrolls through the phone's gallery, he says, "I think Dean could handle the DID. It took a while, but they were getting there. This year, though, after Dean went missing -- that's when things really spiraled out of control. And it's not just how often the switches come now, or how much time Sam keeps losing, not even me being worried about his safety if it happens when he's out alone. It's not _just_ that."

Kate follows his finger swiping up on the screen. "Okay," she says, and she's about to ask what else he means when Cas finds what he was looking for, and flips the phone to let her get a better look. "Here, this is what I wanted you to see."

Sam's smile in the picture is wider than Kate has ever seen it. That's the first thing she notices. He's wearing a red flannel shirt and an old pair of jeans, looking much more comfortable somehow than he does in the grey sweats and hospital-issued long T that he wears in here. But that's not what gets her attention; it's how _alive_ he looks. This couldn’t have been taken too long ago, but it looks like a relic from another lifetime. Sam is smiling with full intent, eyes shining and face open and relaxed. She’s never witnessed that here, didn’t even imagine it was possible. The Sam she knows looks like he’s been under the crushing weight of pain forever. His younger alters may look a bit like the picture, sometimes, when they’re mercifully happy for a moment or two; but no, not even then.

She assumes the other guy with short, lighter hair throwing his head back, laughing even harder than Sam, is the older brother. She can sort of make out the shape of a car that they’re leaning against, and recognizes the reflection in the windshield.

“You took this,” she says. 

Cas nods. He’s holding the phone steady, thumb hovering over the screen, ready to make sure the picture doesn’t go dark. She wonders if he looks at it often.

“When was this taken?”

Cas doesn’t need to search his memory for the answer. “Three and a half years ago. We were on a - - it was back when we all still worked together.”

As careful as Sam. She decides to just ask; let him refuse to answer, if that’s the way things are. At least that will tell her they were doing something shady, which she already highly suspects is the case.

“What line of work were you guys in, exactly? I can never get a clear answer out of Sam.”

Cas pulls his arm away, turns the screen off and slides the phone back into his coat pocket carefully, like he’s handling a rare book. _Strange dude._ “I can’t tell you,” he says plainly, without a hint of apology in his voice. “Sam wouldn’t want me to. And it doesn’t matter, not anymore.”

“Well, it could matter if it has something to do with Sam’s condition right now. Did Dean go missing while you were… while you were on one of those jobs, whatever it was?”

Cas nods, offering her no further information. 

She presses on. “Jay told me he thought Dean wanted to stay missing. He thinks Dean is staying away to protect Sam, and that he probably doesn’t know he’s in here. Do you think so, too?”

Cas avoids her gaze as he says, “yes. As far as I can tell. I’ve been leaving messages, but I’m not sure Dean checks them that often. Maybe he can’t. We just don’t know.”

Kate sighs. “Okay. That’s too bad. I get that you can’t tell me much, but on the off chance that you do talk to Dean, will you give him my number? Maybe text it to him, or leave it in a message?”

There’s a long silence that hangs in the air between them before Cas says, “okay. I will. If we talk.”

She clears her throat. “This might sound redundant after what you’ve told me, but are he and Sam close? I mean, I get that they’ve been working together for years, so obviously they spend a lot of time with each other. But not all siblings who work together actually get along, you know -- familial obligations aside.”

Castiel’s eyes soften as he says, “yeah, they’re close.” 

“Not the fighting kind of brothers, then.”

“Oh, they fight. Not so much in recent years, but yeah, they did in the past. They weren't doing so well when I first met them.” He looks like the memory of whatever conflict the brothers were embroiled in makes him uneasy, and she wonders if he was involved. She knows better than to ask about that.

“But all in all, I think they liked working together, yes. Maybe not always, not right away, but they did. And they’d been getting along for a long time before Dean disappeared, even with - - you know, with all the complexities of Sam's others surfacing so often. Most of them got along with Dean, too.”

“Right. That’s never a given. And how did Dean feel about them?” 

Cas shrugs. “It was an adjustment. I mean, they’d always been there in some form, so it’s not like they suddenly appeared out of the blue, but it’s different when you know what you’re dealing with. And they really did become more… present, I guess, in recent years. It’s never easy for Dean to look at Sam and know he’s talking to someone else. Brings back some bad memories for him.”

“Oh?” Kate tries not to sound like she knows this is a meaningful piece of information. People clam up if they feel studied. “What do you mean?”

Cas shakes his head. “Can’t go into that. It’s… it’s not my story to tell.” 

They sit in silence for a moment. Kate suppresses the urge to say _please just tell me,_ instead only says, “you’re not going to eat that pie? It actually looks halfway decent.”

Cas looks at the plate like he forgot eating was even an option. “Oh, no. I - - I changed my mind. Would you like to— ”

She laughs. “No, I’m good. Just thought you might have gotten distracted.”

“Okay.” Castiel gently nudges the plate a few inches away, watches it where it sits on the table like it’s waiting for a third party to their conversation that hasn’t shown up yet. He spends a long time staring out the window before he speaks again, and she doesn’t rush him.

“You know, I just worry about how things are going to be until we find Dean again. He and Sam have been through a lot, and they don’t exactly have - - they’re all that’s left of their family. And they’ve been traveling around too much to really make friends that can stick around. On a day-to-day basis, they pretty much only have each other.”

“And you.”

He gives her a small, sad smile. “And me.”

On the way out, as she escorts him to the elevator, she can’t help herself. “You know, I meant what I said, about giving Dean my number if you can.”

Cas nods. “I know you did. I’ll keep trying to reach him.”

“Will we see you next week?”

“Of course.” He looks almost offended for a moment, then seems to shake it off. “I - - I really appreciate you caring so much about what happens to Sam. And Dean would, too.”

Her turn to almost be offended. “It’s what I do,” she says, just as the elevator doors open. “Besides, Sam’s a good guy. I think he deserves a break.”

“He does. He is.”

She stays standing by the elevator long after Cas is gone, staring at the scratched metal, before she turns around and makes her way to Adams’ office instead of her own.

*


	5. Chapter 5

**Summary for the Chapter:**

> **See the fic summary for trigger warnings and disclaimer.**

“You’re not serious.” 

Megan is incredulous, and angry, and Kate can’t really blame her. She’d react the exact same way if one of her colleagues pulled this stunt, too.

“I am.”

“Kate, you can’t - - you just don’t do that. You don’t leave over a patient. That’s just not how things work.”

She shrugs. “I didn’t _really_ threaten to quit. I just told Adams that I’d have to reconsider my priorities if - - “

“If he discharged Sam early.”

“I didn’t put it quite like that, but yeah. He got the message. I won’t be part of something like that again, not with a patient who's at that much of a risk.”

Megan shakes her head. “You know he could have fired you right there and then. He still might.”

“He won’t. We’re short staffed, more than we have been in a decade, from what I hear. Adams is barely keeping the lid on this place as it is, and he knows I’m not the only one who might be looking for better options. Losing more people will cause more trouble than just letting a patient stay.”

Megan doesn’t look convinced. “Well, this is still going to come back and bite you in the ass,” she says. “Listen, I know you’re still learning the ropes, and - - “

“Oh, stop it with the New Girl Routine.”

“Well, you are. And you need to know this -- you do not throw yourself under the bus like that every time a patient needs more time than they get. You’ll be out of here and out of work in no time if you keep doing that.”

“I know.”

“Well, then, don’t go dive bombing the goddam chief of psychiatry over a patient’s discharge like that! Even if it’s a patient you like.”

Kate sighs. “It’s not a matter of _liking_ him, Megan. It’s a matter of keeping him alive. I told Adams that, too -- that’s probably why he caved. Not that he gives a shit, but I think he’s worried that if I quit over this AND another patient dies right after being discharged, I might speak up. And someone might listen.”

Megan looks exasperated. “You’re so naive, Katie. Seriously.”

“I might be. Look, I don’t think anyone high up in the system cares, okay? I’m not an idiot. I know Adams and the hospital have their asses legally covered about things like that. But bad PR is a consideration, too.” She looks down the hall. “I took a chance. I couldn’t let the guy go when I knew what that meant for him.”

Megan follows her gaze. "You gonna tell him now? He's been having a bad day so far. Might give him some relief to know that he's staying, for now."

Kate's heart sinks. "How bad?"

"Well, you saw him this morning, right? When you came in?"

"Yeah, for like a second. He did look like he hadn't slept. Did they give him something for that?"

Megan nods, solemn. "Didn't work. He was sitting up in bed the entire night, and I'm pretty sure he was shaking, too. He always tries to hide it, but he _looked_ shaky. And he was all over the place during group -- Gina escorted him out and had him sit with me for a while, because he kept losing track of where he was. He was panicking."

 _Shit._ "Makes sense, considering he was up all night again. His dissociation gets worse when that happens."

"Yeah, I know. I sent him to his room to rest about twenty minutes ago, so maybe he fell asleep, now that it's daylight and he feels safer. I don't know, I hope he did. But if he's awake, maybe the news will do him some good."

"Yeah. I'll go check."

*

Sam is nowhere near asleep. He’s sitting on his bed when she comes in, gently rocking back and forth, his eyes closed. It never gets any easier, seeing people so utterly consumed by pain. At least, it hasn’t gotten easier so far. 

"Sam?"

No response. 

She has no clue what name to use, and she isn't sure yet that it _is_ one of his alters she's looking at. Either way, she tries to sound as friendly and nonthreatening as possible. "Hey, it's okay. It's okay. Can you open your eyes for me?"

The man on the bed shakes his head, says nothing.

"You sure? You think maybe you could give it a try?"

He hugs himself, long fingers digging into the sides of his arms. "N- - no. Can't."

"Maybe we can find a way, even if it's a bit scary right now. Let's try something. How about you open your eyes just a tiny bit, and take a quick peek around? You can close them right back." If it _is_ one of his more distressed alters, especially the younger ones, she knows reminding them where they are is key. 

She doesn't often admit even to herself that she's worried about Sam getting stuck in the back if he gets too overwhelmed, but right now she is. She remembers the time Jay took over and refused to leave for days; how confused and shocked Sam was when he finally emerged to find that almost a week had gone by, and that the other patients now avoided his presence. Took a while to fix the damage _that_ caused.

Sam -- or whoever it is at the moment -- shakes his head. "Dangerous," he blurts out, "can't, we're not allowed, 's not - - not safe."

"To have your eyes open?"

He gives her a quick nod, and even that movement is different, like a child's somehow. This is a lot like what she saw when she found him -- well, Evan -- hiding behind that door. 

She hasn't been able to get too much info about Sam's early childhood, other than that general "we moved around a lot." Sam honestly doesn't seem to remember, a price which she knows the mind often has to pay for burying the unthinkable: sometimes things in its periphery are gone, too. And so figuring out the circumstances in which each part was created is hard, an archeological dig of sorts.   
  
But this right here, in front of her, is at least one heartbreaking clue; this is someone who saw too much, too young. Who learned the hard way, and has decided not to see anything ever again.

"What happens if you open your eyes?"

She doesn't expect a clear answer, and she doesn't get one. He just shrugs, curling his toes against the blanket. "Can't."

She sighs. "Okay. What do you need? What can help you feel less scared right now?"

He seems surprised at the question. "I'm okay," he says, eyes still closed, "not s-scared."

Kate barely suppresses a sigh. Whoever this is, they're unaware of their own distress _._ This isn't new, either; she's seen Sam wiping away tears that he had no idea he had cried, has seen him distractedly say that he was "okay, why?" while he was bleeding. There are walls in this man's mind that she can't quite grasp, and sometimes she feels like she's slamming into them head first. 

"Well, you know, you're sitting like you're trying to make yourself as small as possible. And you're shaking. That looks like fear to me." She says it as gently as she can, but the observation still rings a little blunt. The person in Sam's body flinches a bit, his breath rasping, before he says, "Oh. O - okay."

Obedient. He won't even argue with her. This is someone very young, easily intimidated; far removed from the opinionated Sam that she knows. Depressed and exhausted as he might be, Sam still bristles at anyone trying to tell him how he feels. Same for Jay, obviously.

So one of the Littles, then. She considers her next move. The current group activity started 15 minutes ago, and they usually don't let patients in if they're this late -- another one of Adams' "teaching accountability" rules -- but they'll make an exception for a patient who was delayed by a staff member who vouches for them. 

"Let's go to art therapy, okay? I know you like making stuff." It's a gamble, because not all of Sam's child others are equally interested in these activities; but a few of them seem to find some modicum of comfort in being around other people, at least. 

The kid's face lights up. "I can draw," he says, then instantly seems to doubt himself. "I think. I won't make a mess, I won't. Promise." 

Kate smiles at him through the ache in her chest, _always so convinced they're in trouble, all of them but especially the little ones_. "We can ask Gwen, but I'm pretty sure you're allowed. And if not, there's other stuff to do, right?"

He nods dutifully, getting up from the bed and standing by her side, anxiously chewing on the edge of his long shirt sleeve. His gaze wanders up to the ceiling and around the room, and there's a hopelessness about it that makes her think of a long-abandoned shelter dog wandering the small parameter of its cage. Not really looking for anything, not anymore, but happy for any distraction. "Yeah."

*

Luke looks up from the clay sculpture he’s frowning at as they enter. He studies Sam’s face for only a second or two before he says, casually, “hey, kid.” 

Kate's first thought is _How did he know?_ But she gives up on that question as she continues to watch the two men. Luke pulls back a chair that's been left empty next to him -- probably because people know Sam is usually the one who takes it -- and the boy standing nervously by her side seems to find his courage, stepping forward to take a seat at the long table. He pulls the chair close to Luke, sitting nearly shoulder to shoulder with him in Sam’s tall frame, staring curiously at the piece Luke is working on. 

"What's that?"

Luke scoffs. "Supposed to be a house, but the damn thing isn't coming together. It's way more complicated than I thought."

The boy looks at the lump of grey clay in confusion bordering on disbelief. "A house?" 

"You know, a little one, like for a paperweight or something. It's meant to look like the house I grew up in."

"Oh." She can tell by the immediate shoulder slump that this isn't a safe subject, not even as a design idea. Not that she needed that indicator to remember; home is rarely associated with safety or comfort for her complex post-trauma patients, especially their childhood home. And least of all for a child alter.

Luke seems to sense that, too; he's quick to shift the focus, pointing at the shelf full of half-finished works by the barred window. "Which one's yours?" 

He gets a helpless shrug.

"Don't know?"

"Uh-uh."

"That's okay." Luke studies the features of the person seated by him for a moment, like he’s trying to make sure. "Evan?"

A shy nod. _Oh. It_ **is** _Evan, then._ Kate wonders why she didn't just ask. But it’s always hard, for some reason. Some of Sam's younger others seem heartbreakingly surprised by the fact that she doesn’t know their name; worse still, some of them seem scared to tell her their name when asked. If they have one, that is. 

Evan rubs his eyes, looking both confused and frustrated. "Don't- - don't know what to do," he confesses, then perks up a bit as he adds, "we're allowed -- um, Kate says we can draw."

"Oh yeah?" Luke cranes his neck, trying to find the art therapist. "That's cool. We just need to ask Gwen if you can use some paper and crayons today. You like crayons, right?" 

Evan nods again, eyes widening. "I'm gonna draw a dinosaur," he predicts, then frowns. "No, maybe not. Maybe a dragon." 

Luke laughs. "Same thing, really, but okay."

Kate chokes back her own laughter at Evan's appalled expression. "No 's not," he says, "it’s not the same thing. Dinosaurs don't spit fire." 

Luke raises his arms in mock surrender. "True, true. I didn't think about that. Oh hey, there you go, there's some paper over there by the red paint."

Kate makes her way over to Gwen, who's in the corner of the big room, trying to juggle organizing the materials and simultaneously talking to a few of the patients who need a minute. 

"Still no assistant, huh?"

Gwen lifts her head, her face brightening. "Hey! No, not yet." She accompanies the words with a look that says _of course not._ "What's up? I saw you bring Sam in."

"Yeah. Well, it's Evan, right now. Been a rough morning."

Gwen glances at the man standing by the long row of tables that she pushed together before they started. "I heard. Rough night, too. Okay, I'll give him some room for now -- looks like he found what he needs."

They watch as Evan presses a sheet of paper against the wall and tries to draw, forgetting to sit back down, perilously close to breaking the green crayon as he struggles with the uncomfortable angle. Luke pulls on his shirt. "Hey, sit down, use the table. Come on." 

Kate can’t help but smile. “Does he always do this? Watch out for the kids like that when they’re in the front?”

Gwen nods. “If he’s doing okay, yeah. On his bad days he’s - - well, he's too deep under to care.” 

Kate remembers. Luke sitting at the table, staring lifelessly at a blank piece of paper, his eyes hollow with despair. His downward spirals are so bad, they look physically painful. They may well be.

But today he seems to be in a relatively good mood, amused and friendly with Evan, taking an interest in what the boy is trying to draw. “Those scales are really awesome,” he says, lowering his head to get a better look at the dragon. “Like a snake, right. It’s gonna be really scary.”

Evan nods distractedly, hand hovering over the plastic bowl full of crayons and pencils, trying to decide on another color. “Yeah, it's MY dragon,” he says, finally settling on purple. “It kills all the bad guys. It never sleeps, so it shoots fire if they try to get me.” He sounds proud. Kate swallows hard, turns away.

“I’ll see you later,” she tells Gwen, whose attention has already been diverted to what looks like a conflict brewing in the far corner of the big room. 

As she walks down the hall to her office, no matter how hard she tries, Kate can’t shake the thought of how -- and _when_ \-- Sam and his others learned that sleep was a risk. 

Sometimes she just wants the world to burn. 

*

Thursday through Friday go pretty much without incident, which isn't ever a given. Weekends are not easy on people in the ward; no group, no real activities to speak of. Too much empty time, too much pain roaming around the long halls like a school of piranhas. You can feel the tension rise the closer it gets to Friday. Not that surprising, really; like holidays, like visitation days, weekends tend to stir some things up. They see more breakdowns on weekends, people get more suicidal. She worries about at least three of her patients who she knows will have an especially rough time, asks the weekend shift to watch out for them extra; but for once, Sam isn't one of the names on that list. She told him, once he was back, that he wouldn't be discharged any time soon -- not unless he asked to be -- and she could tell something in him relaxed a bit after that. She'll ask him on Monday why he hasn't brought the subject up in therapy, why she only heard about his worry from Jay. But for now, at least, she feels like she can let go just a little. That Sam knowing he's not headed for yet another life change means that he's safe for now.

His others seem to sense that, too. She meets the Littles more on Friday than she has in a while -- Evan and another, even younger alter front during different times of the day, and she isn't surprised to see them. She knows by now that systems, even seemingly chaotic ones, have their rhyme and reason; when possible, they tend to send forward the parts that either need to be helped, or that are best equipped to handle what's going on at the moment. 

It's not something she can always count on, and certainly not predict. But she's seen enough to know that child alters come out more when people feel a bit safer. It can be painful, sometimes, to see how little it takes for those wounded kids to make their way out -- how relative the concept of safety can be for those who have been robbed of it again and again. Sometimes the mildest form of relief opens that door.

And so no, it doesn't surprise her to see Sam's age drop during pet therapy, almost as soon as the golden retriever crosses the room to approach him. The change is gradual, but still faster than usual for Sam; what starts out as a soft, careful "hey, buddy, come here", turns into a quiet mumble as Sam crouches down on the floor and presses his face against the dog's yellow fur. Toby nuzzles Sam's shoulder in return and wags his tail, good-natured and friendly as usual. 

Kate can see the way Sam's posture relaxes a bit, watches as his arms come up to wrap around the dog for a hug. His voice is barely different, but different enough as he chants, "good doggie. Bones, Bones, Bonesie - - "

Evan? Probably Evan.

She wonders if Sam had a dog named Bones. Makes a mental note to ask him about it. If there was a dog like that, she hopes Sam met it at a friend's house or in a neighbor's yard; she suspects that pets were too much of a constant to last in the nomadic lifestyle that Sam and his brother were apparently born into. Feels like Sam was the kind of kid that didn't _get_ to have a dog, even though he and most of his alters seem to desperately love animals.

She remains standing in the doorway, the way she always does during this group; she can only manage to sneak in for a minute or two every week, but this is by far her favorite slot in the ward schedule. Always has been. The way people seem to light up during their interaction with the animals is almost magical, even if it is temporary. Sometimes the mere reminder of how it feels to experience something other than pain is crucial. She remembers how depression, for one, can kill all memory of that.

Shelby crouches down by the man and the dog, careful not to touch either of them. She’s known Sam and his others long enough. She also knows that Sam would have remembered Toby, unlike the delighted kid who’s still wrapping his arms around the dog, refusing to let go."You like this one, huh," she says. "I think he likes you, too. So you think his name should be Bones?"

She gets an excited "yeah!" before Sam -- well, clearly not Sam -- raises his head to see who he's talking to. "Bones," he says again, then flinches as the dog sneezes loudly. "Oh, gross."

Both Shelby and Kate laugh as he wipes his neck. "You're a good boy," he declares into the dog's ear, like he wants to make sure the message isn't lost. "You're a good boy, it's okay. It's okay, it's okay, it's okay. No one's mad."

Shelby pats the dog’s head. “That’s right, we’re okay. Just a sneeze, right? Clears the snout right up.”

Kate can tell a couple of the other patients in the room are distracted, watching the exchange. She doesn't comment on that; most people in the ward have figured out what Sam is dealing with, and the topic isn't exactly tiptoed around. He's also not the only person openly dealing with DID in here. She knows that’s not always the case in other psych wards; she's painfully aware of how people with this particular disorder can come and go without ever being recognized, without their switches being truly addressed, and without a correct diagnosis. Most of her DID and OSDD patients have been through that ringer. That, at least, is a sin this ward isn't guilty of, despite everything. Not yet anyway.

Luke raises his voice from the corner. "Hey, come check out the hamsters when you're done bugging the dog. They're cute as hell. We can feed them some lettuce this time."

The "okay" he gets is so faint and unconvincing that Luke laughs, too. "Yeah, alright. Not gonna hold my breath."

*

Kate thinks of the boy and his dog on Sunday night, as she and Angus curl up -- okay, share two ends of the same couch; it's still Angus, he has his dignity -- in front of the TV in the living room. She watches the cat's reaction when Kiran gets home, and the casual way in which it settles on her roommate's stomach once Kiran is done asking for forgiveness and offering treats, and flops down tiredly on the couch.

"He was _not_ a happy camper this week," she says. "Don't be too impressed by all that 'remind me who you are again' bullshit."

Kiran snorts. "Oh, yeah. He's just angry with me. He knows I love him." He gently tugs on the cat's paw, gets a stern _meow_ that Kate knows means teasing will not be tolerated. "Right? You know I love ya. Did you think daddy went away for good? I'm so sorry."

Kate pushes away the thought of a dog named Bones waiting for his human to return, somewhere in the shadowy realm that is Sam's past. _Nope, not tonight. Don't start._

She gets up, nudges Kiran’s ankle. "You up for a movie? I'll make the popcorn."

*


	6. Chapter 6

**Summary for the Chapter:**

> **See the fic summary for trigger warnings and disclaimer.**

The weeks seem to blend together, for a while. Kate considers that a good thing, a sign of tentative stability, maybe. She and Sam manage to do what she hopes is meaningful work in therapy, though she knows there are depths that they'll never reach. Not everything is safe to unpack right now, certainly not with a time limit. Sam seems to embrace this, and she can't help but wonder if he truly plans to find a therapist once he gets out; if he can afford to, financially and logistically. Emotionally. 

Still, they do what they can. She gets to know Evan better; a few of the other alters, as well. It feels like Sam’s system may trust her a bit more, now. She hasn’t been deemed completely safe yet, but she seems to have earned a key to at least some rooms in the complex structure that is his consciousness. No small feat, by any means.

Except Jay remains uncharacteristically absent, which is both an unspoken, guilty sort of relief, and a worry that she and Sam share. Jay’s silence makes them both wonder.

"Do you think he could be… gone?" Sam asks her one day in her office. He's studying the scars on his arms, bright red lines bracketed by the fading dot marks of removed stitches. It'll take a long time before they turn purple, then pink, then eventually white, like the other remnants of old battles that mark his body. _I don't think they're all self-inflicted,_ Megan told her when Sam was first admitted. Kate doesn't either, but that seems to be one of the things that Sam isn't ready to touch.

"You mean Jay? No, I don't think he’s gone for good."

Sam sighs. "How do you know?"

"Well, alters don't just disappear one day. They can change, they can integrate, but when that happens people still feel them there; just different, more... blended. They don't simply get erased. As far as I can tell, when an alter who's usually very present drops off the radar, that means they're sort of - - " she searches for the right word.

Sam's tone is undeniably sarcastic as he says, "what, hibernating?"

"Well, in a way. Maybe more _forced_ into hibernation. I've had patients who lost touch with an alter, sometimes more than one alter, for a long time. It usually ended up having to do with a struggle inside their system."

Sam frowns. "I don't - - I mean, there's always a bunch of us pulling in different directions, but I don't feel like there's been this _war_ inside. And I couldn't make any of them stay gone even if I wanted to. I can beg them not to take the wheel, but they don't really… they don't usually listen. It goes the other way, too -- there were times when I couldn’t take it anymore, and I _wanted_ someone else to front. And nothing happened, no matter how bad it got."

Kate nods. "It takes a lot of work to communicate with everyone inside, and even then, I think alters tend to come out when it's right for them, or for the entire system. Not necessarily when it's convenient for the host."

Sam's frown deepens. "I _hate_ that word, ‘host’. It's just… I don't know, it makes it sound like I'm incubating an alien. Or throwing a fucking party."

Kate wasn’t expecting to smile, but she does. "I didn't think about that. Okay, well, some people say ANP instead of host. It stands for 'Apparently Normal Part'. I don't love the use of 'normal', but you can sort of get what it means here."

Sam sighs again. "It means parts that aren't as wounded, right? That can deal with everyday stuff better. Like the way I’m usually the one fronting when we need to talk to people outside, or go to classes, back when I was in school."

"Yeah. I mean, those parts are wounded, too, just in less visible ways. Some people's ANP's don't remember their trauma at all, so they can carry different burdens, they’re less overwhelmed. That can change with time and therapy, but it isn't rare for them to start off like that.” 

She keeps talking, well aware that Sam might not like the idea of therapy making him remember more than he currently does. “Anyway, whether you call them hosts or ANP's, they're important. They're pretty much what allows folks with DID to stay afloat, to a degree. To socialize, to work, to parent -- to just be in the world, you know? Despite having all that immense pain and distress inside. And I'm sure I don't need to tell you this, but it's also what keeps the condition off everyone else's radar, which is partly why so many people think DID is rare." 

Sam lets out a bitter chuckle. "Yeah, no kidding."

Kate knows this is a sore subject. The secretive nature of the disorder makes it a double edged sword; people -- some of her colleagues included -- assume that they've never met anyone with DID, because the switches would have been obvious and alters would have identified themselves. That myth of complete visibility doesn’t skip many of her patients, either; it feeds their self doubt, and only gets amplified by people in their lives protesting that they would have _seen_ the switches if the condition were real. She often has a hard time explaining to her patients’ loved ones that it’s not always easy to know alters for what they are, not when you lack the context. Just like Sam's brother and Sam's best friend did, at first. 

Except Cas and Dean seem to have caught up with the reality of Sam’s condition at some point, seem to have somehow adjusted to it, despite what sounds like zero access to outside resources. She knows how uncommon that relative acceptance is. And the thought of the ignorance Sam likely faced once he did seek help, just before he was hospitalized, makes it even sadder. There’s so much inherent loneliness in DID, and sometimes she wonders if that’s part of what drove her to make it her main focus.

A question for another day.

She studies Sam’s face as she says, "I'm guessing you've seen your share of psychiatrists who had no clue that they only ever spoke to Jay, right?"

Sam nods. "And a few who spoke to - - well, I don't know her name. Luke says she's come out a few times here in the ward, too, but I only remember tiny bits and pieces of what happens when she’s around. If that."

"And the doctors who happened to speak to her, and not to you, didn't realize."

Sam shakes his head, stares out the window. "I don't think so. I read their referrals. One was in the ER, I think. The other one was - - I don't remember where that was. Anyway, both of them assumed she was me, and they both thought I was clinically depressed. One of them wrote something vague about food issues, too. I’m not sure what would have gotten him to _that_ conclusion, but I mean, it’s possible. And I guess she never corrected them when they used male pronouns, or they would have written something about that. Right?"

"Most likely, yeah." Kate has only had a few patients whose others outed themselves during initial evaluation; most alters she’s spoken to didn't seem to trust strangers enough to do that, least of all new psychiatrists. And patients whose alters _had_ spoken out, had said outright that they were someone separate from the person the evaluator assumed they were speaking to -- well, they usually came in with a plethora of misdiagnoses. Psychosis seems to be an especially popular interpretation, which means many of them come in heavily medicated, too. Some tales of professional responses that her patients have faced still make her angry to think about; if nothing else, they make it painfully clear that most alters’ mistrust and caution are well-earned. And not just a result of the original trauma, either.

Sam is still staring out the window, and Kate watches him for a moment before she realizes he isn't so much thinking as he is starting to dissociate again. She’s learned that talking about an alter can occasionally bring them forward, and she now wonders if she's about to meet that quiet, pained girl again. But Sam only blinks a few times, takes a deep breath, tears his gaze away from the scenery outside. Still here. "Sorry, what was I saying?"

Kate smiles at him. "We were talking about how even when your alters interact with people, they don't usually let them know that they're not you."

"Right. I mean, here in the hospital they do. Sometimes." Sam moves uneasily in his seat. "I don't - - I sort of feel bad about that."

She knows him well enough by now to guess where this is going. "Because you wonder why here, and not that often outside?"

Sam avoids her eyes as he says, his voice low, "yeah. Maybe I'm somehow - - I don't know, letting it happen more because I know it's acceptable in here. Maybe - - "

"Maybe none of it is real? Is that where we're headed?" She tries not to sound frustrated. Reminds herself that Sam grew up in a world that _would_ inspire constant self-doubt. This is true for so many other emotional issues, too; but when there's memory loss involved, that toxic skepticism is even harder to root out.

Sam's perception of his situation is a minefield, one that needs to be navigated carefully. Sometimes she watches as other patients randomly ask him about it -- how it feels to switch, or if he _really_ can't remember something that just happened. Sam is too polite to refuse to answer, usually; but she’s noticed the way his face goes blank, the flat, emotionless way in which he talks about it. Always a warning sign with traumatized people; she's learned that the hard way, and not just at work, either.

She knows that the complete lack of emotion often marks the site of an open grave, a wound so deep it's impossible to even come near. That sudden drop into numbness is some people's last line of defense. And Sam's sessions with her are laden with those moments, even when he doesn't quite switch. She watches him go flat and dull every time he talks about the past, when he describes incidents that are clearly traumatic. She recognizes that detachment, enough to know that Sam doesn't even notice it. Makes sense that he wouldn't, considering how much deeper his dissociation goes. 

She wishes she could tell him, _I've seen this so many times before, Sam, you check every goddamn box. You check boxes that you don't even know exist. You're not making up these wounds._

But she can't, and it wouldn't help, anyway. 

She thinks for a moment. "Let's go at this a different way, this time. I want to ask you something, and I want you to try and stay as present as you can while we talk about it. Do your best. Alright?"

Sam tenses up in his seat. "Sure."

"Yeah? Okay. I want you to tell me this, if you can: where do you go when one of the others takes over? Do you know?"

Sam looks at her for a few long seconds before averting his gaze like he's embarrassed. He studies the floor like he'll find better answers there. "I think for some of it I’m around, I just - - it's like I get pushed way back. Like all I can do is watch. I mean, I've told you this. I can see and hear what Jay does, a lot of the time."

She nods. "But not so much with the younger ones."

"Yeah, not so much with them. I mean, some of what happens comes back when you guys tell me about it after, or when Cas and Dean did, but I can't… it's like I don't have access to that memory. Not on my own. Most times, I don't even know there's a chunk missing." 

He seems frustrated, digs his fingers into his thigh and presses his back against the chair. Already trying hard to keep himself grounded. 

"But that's the point, though,” he says. “It can't really be DID if I'm _there_ , right? There's probably some other explanation." 

And there’s that eternal doubt. Sam is looking up at her now, again, and she hates how desperate he seems. She has yet to meet a patient with this disorder who simply accepts it, not at first. Sometimes not ever. And Sam’s doubt is no different; he constantly sways between trying to believe, and hoping that there’s been a mistake. That this can all be explained away in some form that doesn’t include trauma.

"It's actually not that uncommon for people with DID to remain halfway present when an alter is in charge," she says, and watches Sam's face fall. "I mean, it varies. Some people have complete amnesia for what happens while their others are fronting. They literally have no idea. Some remember bits and pieces, like a dream. And yeah, some people are just _there_ for a lot of it, in that back seat. And it can be a mix of all three. You've heard me mention co-consciousness, right?"

Sam shrugs. "Yeah, but - - I don't know, I still think it can't be that. Not the way it is for me. It wouldn’t be this… mild."

 _You wouldn't use that word if you could see what we see when you’re gone,_ she thinks, but instead she says, "Sam, DID exists on a very wide spectrum. And there's also OSDD, which is sort of a different branch on the same tree. Listen, honestly? At the end of the day -- at least from my point of view -- it's like neighborhoods in the same city. Where exactly you’re located is important, but not as crucial as the fact that you’re there at all. What _that_ means. Because this division of consciousness -- that's something very specific that happens to people who have been through too much, too early, and for too long." She watches Sam's face as she says this. Not like she hasn't mentioned this before, but still, never an easy thing to hear.

"The way we see it, if you're subjected to those acute levels of constant stress so early in life, sometimes the mind doesn't get to work things out like it was meant to. It never gets to integrate parts of your consciousness, your self, that usually get the chance to become cohesive, because - - well, because sometimes life is so bad that it makes compartmentalizing crucial. Children do that because they’re living through pain that’s so severe, they can’t survive it otherwise. And this is a well-known thing, Sam. That you don't develop that particular skill set unless you had a dire need for it. That’s the part that we work to understand."

Sam looks drained as he says, "I hear you. I just - - I don't know why I keep going down that rabbit hole of whether or not I have this. Why it even matters."

Kate sighs. "Well, I sort of get why the definition can be a thing, sometimes. People who grow up in--" she wants to say _abusive_ , picks a different word -- "in traumatizing surroundings usually get invalidated from day one. You know? They learn that their distress doesn't matter, or sometimes they're told it doesn't even exist. Then, when they start showing signs that something’s wrong -- anxiety, or depression, or anything else -- maybe they hear that they're trouble. Or that they're weird. Or that they're weak; that they could just stop it if they really wanted to. If they don’t have a clear grasp of what caused their pain, which is very common, it becomes very hard to resist that narrative. Hard to say, ‘no, I’m like this because I’ve been hurt’. And later - - well, you know, it's not like the world gets more tolerant when you grow up and become a still-suffering adult."

A shadow flits across Sam's face, something that's gone too fast for her to read. Maybe anger. "No, it doesn't." 

"Anyway, my point is, that's just the basis that many people with DID start from, as far as trusting their own experience. That right there is enough to make you doubt yourself. Then there's everything else, like trying to get a clear picture out of memories that are incomplete and hard to make sense of."

Sam sighs. "I guess."

He looks down at his scars again. "I don't know where I go," he says. "For the parts when I'm not there at all. I mean, I always... think I'm there. I just find out later that things happened that I don't know about. It's not like I go to sleep during it, I don't _dream_. I'm just - - I'm just gone. And then I'm not."

Kate nods. "Sam, that's just it. That's what I'm saying. Everything you've ever described, everything I and the rest of the staff have seen you go through -- it's very familiar. We see it all the time.” Apparently she _is_ going to say it after all. “You're a smart guy, but I don't think you'd be able to come up with so much, and get so many nuances right, even if you did have some unconscious desire to believe that you had DID. Which, honestly? I can think of much easier disorders to convince yourself that you have. I mean, _seriously_."

Sam lets out a choked laugh that neither of them saw coming. "Right?"

She smiles back at him. "Dude," she says, shaking her head. 

Sam snorts, wipes at his eyes as quickly as he can manage. "I hate this. Can I say I hate this? I mean, have I mentioned that yet?"

"Once or twice," she says, handing him the box of tissues. 

"Okay. Thought I'd make sure."

*


	7. Chapter 7

**Summary for the Chapter:**

> **See the fic summary for trigger warnings and disclaimer.**

It’s actually a beautiful morning, the weather outside mild enough that Kate decides to suggest an unplanned outing during the staff meeting. They can’t convince all the patients to go down to the yard or the garden -- they’d be lucky with half of them, really, people aren’t here because they’re emotionally available to appreciate nature -- but still, it’d be nice if the staff decided to encourage at least _some_ trips outside. 

She is quickly reminded that there’s no logistical way to do that, sags in her chair, exchanges a “you have to try” shrug with Mateo. They move on, the therapists giving quick updates on their patients' current condition, the other staff members providing their own reports on how everyone has been doing in the various groups. Adams doesn't attend these meetings unless he absolutely has to, so at least there's that; Kate is happy with the chief resident running things -- Lee is far more compassionate, probably because she's in the trenches with the rest of them, unlike Adams. But when they get to Sam, the topic of his impending release is still the first thing the resident brings up, before any updates. It's a punch to the gut, but Kate can't begrudge her that -- this is what they need to work with, and ignoring what's coming won't do Sam any favors.

No final date yet, but they have a general idea, and they're all worried. There's talk of available crisis response and resources for Sam outside (poor to non-existent, as usual), of working with him on safety. They all know it's highly likely that his safety _will_ be the first thing that’s compromised. He might get actively suicidal -- Kate thinks about Evan's words as they sat on the floor behind the door in art therapy; how deep that despair has carved itself into Sam's psyche, _even the kids know that he wants to die_. 

Change is dangerous as it is for people who are already stretched too thin by their torment, and being released from a long hospital stay is always a potential tipping point. For someone so devoid of stability, solid daily routines and social support, it's like playing Russian Roulette. She says that, and watches her colleagues deflate in their seats. It feels like they're planning an accident that they're supposed to prevent.

But they have to go over this, and they do. They talk about how, even if Sam handles his suicidal urges, there's Jay to worry about: his definition of guarding the system, and what it means for Sam's physical health. Not to mention how exposed Sam might be if his youngest, most vulnerable, non-communicative alters get triggered into fronting anywhere other than at home, or at least with Cas around. So yeah, risk management. 

It's frustrating as hell, knowing that this is where they are after so much effort -- most of all the effort made by Sam and his others. But this isn't the first patient she's sent out into the world armed with a tourniquet instead of stitches, and he won't be her last. 

It does all feel like the mental health version of combat medicine, these days; not with all of the patients, but with way too many. Patch them up just enough to watch them stagger away, hope they won’t return in even worse shape. Not what she had in mind when she chose this field, but when does anything turn out the way you expected it to, really.

She sighs and closes Sam’s file as Lee says, “okay, we’ll have to get back to this, we're running short on time. Who’s up next?”

*

Kate is looking for some Advil in her desk drawers -- not an uncommon activity for her after staff meetings, which can’t be good -- when she hears the soft, hesitant knock on her door. 

"Yeah, come in."

A few seconds, then the door opens slowly. Sam stays standing in the hall, looking at her like he’s unsure if he is truly allowed in.

Kate smiles at him as she says, "hey. It's okay." She watches the man take a step forward and just stand there, shifting his weight nervously from one foot to the other, still not taking a seat. 

"What's up? How are you doing?"

Sam's eyes are wide and anxious as they scan the room, avoiding hers. "Huh?"

"How do you feel?"

He seems to think for a moment before he says, "okay."

"Really? Because you sort of look like there's something on your mind."

That gets her a nod. "Worried. Yeah."

She considers her next words, still unsure who it is she's looking at. "Do you want to tell me what you're worried about? You can sit down. Okay if I close the door? So that we can have some privacy?"

Sam nods, takes a seat, watches her. Hard to miss the way he tenses up as the door closes, like he's bracing himself for something bad and inevitable. Not the first time he's reacted like that, either. She considers addressing it, but maybe today isn't - -

"Cas found Dean." 

Sam says the words quietly, almost distractedly, and it takes a second for their meaning to sink in. _Holy shit._

"He did? That's - - " she's about to say _great_ , but stops herself. _'Found' can mean too many things_. "Is he alright?" 

Sam nods. "Yeah. He had to go away because someth - - someone was after him. We're not allowed to tell."

"But he's safe now?" 

"Yeah." Sam looks out the window, his gaze unfocused. "Cas says that Dean didn't know I was in here, he didn't know about the hospital. And that he's so worried. And he's coming to see us soon." 

Kate notes the shift in tone, the back and forth between _I_ and _we._ "That's big news," she says, studying Sam's face. "Are you glad he's coming? I know you've been missing him a lot. It’s been a really long wait."

Sam's "yeah" is barely audible. He looks down at the floor, suddenly on the verge of tears.

"You _really_ miss him, huh."

He nods.

"Sam -- is this Sam I'm with, right now?"

He lifts his head, eyes desperate. "Don't know," he admits. "We can't - - it's all mixed up. I'm, I’m here, but Evan is, too. I think."

Sort of makes sense, actually, with that amount of emotional turmoil. "That's okay. We can work with that." She knows this means that she has to be more careful, but parts sharing the front isn't a rare phenomenon, certainly not for Sam. Though it doesn't seem like he remembers that at the moment. 

"When did you find out? About Dean?"

He thinks for a moment. "Yesterday. No, might have been this morning."

It's still morning. "Do you remember what day it is?"

He frowns. "What day - - umm. Wednesday?"

He seems unsure, and then relieved as she nods. Kate smiles at him. "Yeah, it's Wednesday. Okay, just making sure we're on the same page. So Cas called you to let you know? Texted you?" The patients leave their phones in a locked drawer in the nurses station during activities, but it could have been before morning group.

Sam closes his eyes. "He texted. Then he called. I was trying to write back, but I couldn't - - I forgot how to - - " he shakes his head, disgusted. "I forgot how it works. The whole thing. How to get the keyboard up on the screen, what I was even going to type. I was just staring at the phone when he called." 

He sighs. "Luke had to answer for me, because I couldn't remember which one you're supposed to swipe to take the call, red or green."

Kate thinks about how much she wishes Sam didn't judge himself so harshly, especially for what amounts to a tortured brain shorting out under impossible pressure. "Well, with major news like that, I'm not surprised. So will Cas be coming today?"

Another long pause. "Yeah. Um, yeah. Sorry. Today is - - yeah."

 _Not doing well._ This doesn't necessarily mean that Dean being found is cause for distress; good news can have that effect just as easily. Even more so, sometimes. After months of uncertainty, being able to _not_ worry about his brother is probably allowing Sam's anxiety to diminish just a bit. She knows what that can mean to a mind whose only access to relief has been through detachment; she figures if a general dimming of lights is your only respite, that might make you react to comfort by instinctively dissociating when it does come. Kind of a chicken and egg thing.

The fact that positive things like safety and relief can occasionally be triggers is an unexpected observation -- one that she feels like she should have been taught in advance, but has instead had to form through trial and error. And it's part of a larger lesson, too; the counterintuitiveness of it all. Understanding how things that seemingly don't belong together can become linked and enmeshed in the wake of trauma, growing in and around each other like symbiotic plants. Understanding that there's always a reason why that happens. 

She is still studying these connections, maybe always will be. 

Sam blinks at her, slow and unfocused, and she can almost see his mental age changing. Evan is more present now, claiming his space, desperate to ask her for reassurances that Sam knows not to hope for. 

"We're w- - worried," he says, and she wonders again how Sam's voice can sound the same but so very different. "About Dean."

"You are? Why?"

Evan sighs. "Because what if - - what if he doesn't want to talk to us anymore? What if he only wants _Sam_ to come home?" He brings his legs up on the chair, draws his knees close to his chest, the way he so often does. "M- - maybe he forgot. About us."

She wasn't expecting that particular concern. "Well, I haven't met Dean yet, but from what you guys and Cas have told me, he's known about you for a while. He knows that having Sam in his life means having all of you there, too." She tilts her head. "Plus, I don't think you're that easy to forget."

Evan seems surprised, hopeful, then suspicious. "Really?"

"Really. I think you're a smart, sensitive kid who cares a lot, and worries a whole lot. And I think Sam was probably that way as a boy, too. So Dean has some experience with having a little brother who's kind of like you, right?"

Evan considers the idea for a while before he says, "maybe. Dean's our - - he's our big brother?"

Even without knowing Dean, she's grateful that he isn't there to hear that question. "Well, he's Sam's, so I think he might be yours, too. What do you think?"

The boy nods, thoughtful. "Yeah. Not our dad. He's a big brother."

"You thought maybe Dean was your dad?" The thought makes her sad, but not particularly surprised. "Well, I can see that. He's just a few years older than Sam, but a lot older than you."

Another nod, followed by a quick, anxious glance. "Yeah. Dean's - - he's not a dad. He's good. He's a brother."

Kate isn’t sure if it’s the right thing to do, but she still asks. She has to. “You think fathers aren’t so good?”

Evan’s eyes won’t meet hers as he says, “we don’t - - we don’t need - - we got Jay.”

It never occurred to her that some kids in Sam’s system might see an adult alter as a replacement parent. She wonders _why_ it hasn't occurred to her, with Jay pretty much admitting that the letter that made up his name stood for John. For some reason, she filed that fact away and never came back to it. Something about the concept of Sam housing the echo of a possibly-traumatizing parent -- maybe downright abusive, for all she knows -- was too hard to confront. Definitely a failure on her part, one that she needs to discuss in her own counseling.

"Jay takes care of a lot of things that you're scared of, huh." 

Evan's attention has wandered over to a picture on the wall, and he's studying it, riveted, as he says, "yeah. He tells grown ups not to hurt us. And he does the punishments, too. He helps."

Kate's heart drops at the sound of those last words. "What does that mean, 'he does the punishments'? Does Jay hurt you?"

The boy tears his eyes away from the picture, looking surprised. "No, he never hurts us. Only the body. When he has to."

 _Right. The body._ After all this time, she still struggles with that language of separation. The perception behind it.

"And what makes him feel like he has to do that? Do you know?"

Evan shrugs, disinterested the way she imagines a child might be while listening to adults discuss taxes, or rent. "Don't know. We don't pay attention so much. We're far away when Jay comes, we're not allowed to look." 

He thinks for a moment, trying to remember. "When Sam gets hurt real bad, maybe. That's when Jay does it a lot."

That's a semi-new lead. "So Jay hurts the body when other people hurt Sam? Not just when Sam is suffering in general, like sad or scared, but specifically when he's been hurt by another person?"

Evan takes a few seconds to process her words, then nods. "Sometimes." 

_Huh._

Kate thinks back to the times when they've had to deal with what the staff, herself included, refers to as Sam's self-injury. She supposes it's not a wrong definition if you look at the whole thing from a bird's eye view -- Sam's others are part of him and vice versa, and even if he often feels like the body he's in is just a meat suit, it _is_ his. Theirs. The very fact that Jay can abuse it the way he does is proof of that ownership. Zach actually told him that, once. "If you did to someone else half the things you inflict on yourself, you'd be doing time right now. You get that, right?"

Jay just smirked. When Zach pressed him for an answer, he shook his head. "You really have zero clue, huh. You're talking to me about - - listen, I'm already _doing_ time. I'm the one chained up in this body that you're all so goddamn worried about keeping intact. And I'm never getting out." 

He glanced down at the wound on his chest that they had just finished changing the dressing on. "This shit? What, doing a little damage here and there? Oh, _buddy_. You got no idea how much I hold back." 

Kate remembers having to look away, because that tone, and that pitying smile, were just too much. She still caught Jay's exasperated eye roll as he said, "you people need to stop treating it like a fucking crime, that's all I'm saying. This is just me drawing on the walls inside the prison cell. You all make a fuss over it like it means more than that." He shrugged, and she could hear the cold amusement in his voice as he added, "and hey, if Sam whines about it later, you know what? Consider that my fucking consolation prize." 

She remembers the look on Zach's face, too. He had no further observations to offer after that.

Anyway, ownership is just the thing, isn't it. Or part of the thing. Jay's acts of sabotage might be, to him, just a way of passing the time in what feels like eternal incarceration, but they are also acts of taking back ownership. Of the body, of pain, both physical and emotional. Something that Sam and his others have been robbed of repeatedly.

She hates oversimplifying things like that, reducing a behavior so complex and deeply rooted to a mere battle over control; but there's at least an _element_ of reclaiming there that's hard to deny. Even if it takes a dark, destructive turn.

Evan is watching her now, looking worried again. "Are you mad at us?" he says, and she wonders if she's imagining the shakiness in his voice. This kid is so terrified of conflict. So afraid to disappoint, to fall short. 

She softens her voice. "No, I'm not mad. You haven't done anything wrong, Evan. I'm actually very grateful that you're willing to tell me these things. It helps me understand Jay better. And that's good, right?"

Evan nods, though he doesn't look convinced. "Yeah."

She hesitates for a moment before she decides to explore just a little bit further. "Evan, do you know why Jay thinks that punishing the body helps you all when Sam is feeling bad?"

Evan chews on his thumbnail thoughtfully, considers the question. "Because, because it - - if we get the punishment, then we don't have to be scared anymore," he offers. "Maybe."

It's like the heartache always has another level with these kids. Kate tries to sound neutral as she asks, "Jay says that?"

Evan shakes his head. "No, he doesn't say. We just guess."

She wonders again what kind of punishment Sam was subjected to as a child, then maybe again as an adult. Something tells her that this dread isn't all from back then. She can't quite explain why, though.

"You worry about getting punished a lot, huh." 

Evan nods, fidgeting in his seat. "Sometimes," he says in a tone that she's pretty sure means _always_. "When's the dogs coming?"

Takes her a second to get what he's talking about. "Oh, you mean pet therapy? Not for a few days. You love playing with all the animals, huh."

Evan nods, thinking. "I like dogs the best," he says. Then, as an afterthought, "but hamsters are good, too. And the white bird with yellow head. It doesn't bite."

Kate personally feels like they couldn't pay her to let the cockatoo perch on her arm again, but she has to agree that she's never witnessed it peck anyone's eyes out. "Birds can be nice," she says diplomatically. 

Evan nods again, looking out the window. "There's no leafs on the tree," he observes, looking slightly worried.

Kate doesn't address the sudden changes of subject -- they've clearly touched on something too painful for Evan to think about, and if he needs so badly to shift his focus, she isn't going to push. "That's because it's too cold, still," she says. "The leaves will grow back when it's warmer. Flowers, too."

Evan seems relieved. "Yeah," he says. "Dean's coming soon. Maybe even tomorrow. We - - I really want him to come."

"I know. What do you want to do when he gets here? Any plans?"

Evan's smile is wide and happy as he says, "show him our room. And Luke, if he's there. And the dragon, too."

"The purple dragon you drew? Oh, that's a great idea. I think he'll love it. And then what?"

"Then we go in the car. Go home."

_Of course. Of course he thinks Dean is coming to take him home._

She chooses her words carefully. "Well, I think on the first time Dean will just come visit, okay? And then he'll come back another day and you can talk about going home."

Evan sinks in his chair. "Oh."

"But the most important thing is that he's coming, right? I think he'll be really, really happy to see you, too."

Evan looks hopeful. "He will?"

"Yeah, I think so."

"Okay." 

She watches as he stands up, looking down at his feet, troubled. "The floor's far."

"I know. That happens to you sometimes, and then it goes away, remember?"

The boy doesn't seem to believe her reassurance, but just says, "yeah."

"I'll see you later. Real glad about the good news. I'm excited to finally meet Dean."

Evan nods, eyes still on the ground. "Yeah. We miss him a lot. All the time, even when we're sleeping."

 _Oh, kid._ "I know." 

As Evan makes his way to his and Luke's room, one hand carefully tracing the hallway wall, Kate finds herself wondering which part of Sam's system his brother will find waiting for him when he arrives. 

*


	8. Chapter 8

**Summary for the Chapter:**

> ***IMPORTANT TRIGGER WARNING*** : This chapter contains some _aggressive_ DID and trauma denial by an alter. This is quite common, but can be triggering to those who encounter it outside their system on a semi-regular basis already, which is (sadly) most people with DID. 
> 
> So, consider skipping that part of the lobby conversation with Dean if this is a sore subject. And please remember that alters denying DID/OSDD is often a very specific, counterintuitive form of self-defense, and not an indication of how real the system or the condition is.
> 
> *The part to skip is between the phrases _**why you all exist**_ and _**you're a real treat.**_  
> 

*

Dean turns out to be a tall, broad-shouldered man -- taller than he seemed in that picture, standing next to his 6'4 brother -- with short-cropped, sandy hair, and tired eyes that bear little resemblance to Sam's. They can still burn a hole through a concrete wall, though; the man sitting across from her now holds her in a gaze that very clearly says _I don't trust you, tell me everything._ Between him and Cas, it feels like being inexplicably intense is a prerequisite for being part of Sam's life. 

Well, to be fair, there's nothing inexplicable about that. What little she does know about Sam's circumstances, and by association his brother's, doesn't leave much room for confusion about why either of them would be this vigilant.

Dean seems to have come prepared, flashing a badge and offering a well-spun story about a government job that he can't elaborate on; a few months spent off the grid; an unfortunate string of miscommunications with Cas. Kate doesn't buy a word of it -- well, maybe the going off the grid part, but nothing else. She isn't usually the type to immediately assume she's being lied to, but something just feels off. 

Dean himself doesn't, though. Feel off. And she trusts her gut on that, too. He doesn't feel like some asshole who abandoned his younger brother on a whim to go do whatever, and just forgot to call. There's an urgency to how he speaks of Sam, a sort of pain that seems genuine, that he's trying to hide. She can feel him struggle to stay calm and collected. _He's desperate. Desperate to see Sam, but maybe doesn't want to antagonize the staff by demanding it right away._ It actually makes her feel guilty for how she's set this up.

It's not by coincidence that it's just the two of them in her office. Sam is in art therapy, and she made sure to schedule this meeting at that exact time, so that she could at least try to get an initial read on the older brother before he and Sam get reunited. It felt like the logical thing to do, considering how deeply Dean's absence has affected Sam before and during his time here.

Dean clears his throat. "Anyway, it sounds like Cas pretty much told you all about Sam's - - his others." He fidgets a little as he says the last word, and Kate suddenly sees a trace of Sam's body language in his unease, just a hint.

She's allowed to speak to Dean more freely, and so she nods. "Yeah, he did. And we've gotten to know them here -- well, some of them."

Dean simply nods back. Kate finds herself absurdly grateful for that, relieved that she doesn't have to go through the same process with this man that she usually faces with DID patients' loved ones. _Yes, it's a real condition. No, you not noticing alters doesn't mean they haven't been there. No, it's not schizophrenia, that's something entirely different._ At least Dean knows. She suspects that his discomfort, at this stage, is more about Sam's inner world being exposed and vulnerable to a ward full of strangers than it is about any shame or disbelief.

She clears her throat. "How many of Sam's others would you say you've met over the years? Any idea?"

Dean thinks for a moment. "I don't know, it's hard to tell for sure. Only a couple of them have names, and I can't always tell the young ones apart." He looks away, bites his lip before he says, "a scared kid is a scared kid, you know? I know there's more than one or two, but I can't really ask them who they are. Some of them don't talk at all."

"But you know they're of different ages."

Dean sighs. "Looks like, yeah. Some of them draw like they're in kindergarten; some of them sound a lot like Sam did in elementary school. Some don't."

She makes a mental note to come back to that next time they talk. Assuming Dean will agree to. "And the ones who aren't children?" 

Dean's face darkens as he says, "well, there's Jay. I'm told that's the guy's name -- he never gave it to us before. But he's been around for a LONG time. I hear you got to meet him _._ "

Kate nods. "Yes, we did, on multiple occasions. He's been… dominant."

"He lets you know when he's around, doesn't he. Not really a shrinking violet."

She can't help but smile, a little. "No, definitely not." 

Dean shakes his head. "He's a dick, but the real issue is that he's been hurting Sam for years. On and off. And Cas and me, we... we've been trying to remember that he's part of Sam when he does shit like that, but you know. It's not easy."

"Oh, I know."

Dean sighs again. "Anyway, can't say I like the guy, but we made some progress before I… before I had to leave. He was willing to go a little easier on Sam -- well, on the body, Sam keeps telling me it's not him that Jay is attacking, it's the body -- and for a while he did. But Cas tells me it got bad again. He says Jay actually almost killed Sammy, once. Just before he got here."

It's hard to miss the way Dean's voice tightens as he says that, and Kate thinks back to how Sam looked when he checked in. Pale and slow-moving, arms bandaged halfway up to his elbows, weak from blood loss and dehydration despite the transfusions. Jay apparently forgets to drink, too -- none of them is sure if it's an act of self-sabotage or just the result of his disconnect from the body. Yeah, that was a close call, for sure.

"According to Jay, he wasn't trying to kill himself and the rest of Sam's system that time. He referred to it as a slip up, said that he was going for more moderate damage and ended up getting more than he bargained for. Not that it would have mattered what he meant to do if Sam _had_ died, obviously. But generally speaking, from what we've seen here, it looks like Jay isn't suicidal per se."

Dean's eyes harden. "But one of them is."

"At least one, yeah."

Dean studies her face for a long moment before he says, his voice painfully small now, "Sam. Sam wants to die? He's the one?"

Kate nods. "He doesn't outright say it, not anymore -- not since he's been warned that actively suicidal patients get transferred to a more secure ward. It's not usually a place that's too open to working with DID, or even acknowledging that it exists, in some cases. I mean, it's different in every hosp - -"

Dean interrupts her, any hint of vulnerability gone from his voice and his face like it was never there. "Hold on, so you're telling me -- you threatened my brother into keeping quiet when he wants to kill himself? This is what you people consider help?"

She can't really blame the guy for assuming that, or for being this angry. Hell, he's not entirely wrong; the threat of losing what little stability patients have in here is undeniably used in situations like Sam's, where suicidality and self harm go beyond a certain point. And it sucks.

"I'm not going to play coy and pretend that I don't get why you'd say that, Dean, but we do let patients know about the limits of care in this ward for a reason. Sometimes knowing where the line is can help desperate people stay just shy of crossing it, at least long enough for us to do some work with them that will actually ease their pain. It's… not ideal."

Dean seems to be trying hard to rein in his anger as he says, "okay, and has it helped keep Sam safe?"

Fair enough. "Well, you know by now that it hasn't. We can't stop the self-injury completely, just curb it. I do think Jay would have done more damage in other circumstances, but the most recent injury was pretty nasty. So yeah, we haven't really achieved stability in that sense. And I'm definitely worried about what happens once he's released."

Dean stares out the window for a while, his face taking on a familiar expression that makes Kate think of his brother's in-between moments. _These two men have been through_ **_something_ ** _horrific, you'd have to be in utter denial not to notice the signs.  
_

"You know, sometimes it - - it makes talking to Jay feel like a hostage negotiation." It's a harsh sentiment, but Dean sounds like he's commenting on it from far away, somehow. Almost like he's reading aloud a sentence that he meant when he thought it, but can't quite connect to it as it comes out of his mouth. 

Kate leans forward instinctively, trying to make him shift his gaze. The way she does with Sam. 

"Yeah, I guess it can feel that way, huh," she says. "Although I'm guessing Jay would have some choice words to offer about that analogy."

Dean nods, doesn't say anything. 

They only have a few more minutes before art therapy ends. "Listen, Dean, I'd really like to set a time for us to talk some more about this, and about - - well, everything. If that's alright with you."

Dean nods again. Still doesn't make eye contact.

"Yeah? Great. Okay, well, Sam should be out in a couple of minutes. We'll let him know you're here." 

No response this time. Kate studies Dean's face.

"Dean?"

He blinks. "Huh?"

"You okay there? You look kind of… well, you look troubled. I haven't had the chance to ask you how _you're_ doing, coming back to find Sam in here."

Dean does meet her eyes, finally. "I'm good. Really." He follows the statement with what has to be the emptiest, saddest smile she's seen in a while. _Shit, nothing is okay, this man is in some sort of serious trouble, too._

Not like she can do much about that.

*

Group art therapy can go overtime on occasion; the conversation takes an unexpected turn that Gwen doesn't want to interrupt. Or someone is having an extra hard time, and the closing round takes a bit longer. Whatever it is, Kate is grateful that today is one of those days. A few more minutes for Dean to take a breath, which she feels like the man sorely needs. She's retreated to the nurses station to give him and Sam at least the illusion of privacy, and she wouldn't say that she's watching him from there, but - - okay, she's not _not_ watching. From a distance.

Still close enough, though, that she can see Sam's face as he comes in and sees him standing there. Kate thinks to herself that Sam's expression is everything the word **_home_** stands for when home is complicated. She's never seen this look on his face until now; a strange mix of pain and love and familiarity and relief. And then pain again.

Sam takes a long, shaky breath as Dean steps forward to wrap his arms around him.

"I'm so sorry, Sammy. I'm sorry. I didn't know."

Sam nods, chin digging into his brother's shoulder. He holds on to Dean like he can't quite trust that he's actually there; tries to blink away the tears as Dean's hand comes up to pat the back of his head. Kate can't hear what it is that Sam is mumbling, but she thinks he's telling Dean _it's okay._ Partly because Dean hugs him even harder in response. They stand like that for a while.

Later, she'll remember the exact moment when Sam got overwhelmed. Easy to tell this time, because she can see his head beginning to loll sideways against his brother's shoulder, see his knees start to buckle. Almost like someone hit an _off_ switch. 

But then it's over, before Kate even has time to move; Sam blinks again, his eyes growing dull. He lets his arms drop to his sides, takes a step back.

Dean instantly lets go, watching Sam's face. He doesn't say anything for a long moment. Kate wonders if he's trying to get a read on who he's looking at, the way he must have done hundreds, maybe thousands of times with Sam over the years.

She knows who it is before Dean says his name, sounding wary and at the same time painfully exhausted, like he was expecting this. Maybe dreading this.

"Jay."

There's that cold, slightly amused smile again. "Yup," the alter says, leaning casually against the wall in Sam's long frame. He looks Dean up and down. "So you're back? Nice of you to make an appearance." 

He doesn't seem angry, but then he's never really shown much anger during Sam's time in the ward. Jay doesn't feel rage, he siphons it; takes it out calmly and with surgical precision on the body that he's forced to share. 

Dean is probably well aware of that. He doesn't strike Kate as the kind of person who responds mildly to provocation, but his voice remains calm, his words measured and his face neutral as he says, "I know. It's been a while."

Jay snorts. "Yeah, I'd say so." He studies Dean's face, frowns a bit like he's finding something new there that he can't quite recognize. Shrugs.

"So you bailed because what, you figured you've had enough? Sammy losing his marbles wear you out? Can't say I don't get _that._ I just don't get why you'd be dumb enough to come back."

Kate can see Dean's careful, guarded facade slip just a little as he says, "that's not - - that's not what happened."

Jay cocks his head, feigning interest. "Really? So you just up and skip town one day without warning, but that had nothing to do with little brother being a basket case, huh. Just a coincidence."

Dean seems to have given up on civility, eyes darkening and voice just an inch away from menacing as he says, "don't talk about him like that." 

Jay chuckles. "Aww, a little too late to play _Big Brother to the Rescue_ now, but good effort. Anyway, come on, what do you care what I call him? You know he's a fucking mess. And we both know you don't _really_ give a shit."

Kate remembers Jay's words about how the older brother would never leave Sam without a reason, and it occurs to her that he's trying to hit Dean where it hurts the most. She wonders if she should step in as she watches Dean's hands curl into fists by his sides, because apparently Jay knew just where to aim. She decides to hang back; she doubts he'll be punching Jay when he knows it's Sam that will have to carry the bruise. Jay would probably find that hilarious.

Dean shakes his head. "So now I don't give a shit. Well, that's just awesome. You know what, screw you, Jay -- you've been around long enough to know better. And to know that no one gets to talk about Sam like that." He looks Jay dead in the eye as he adds, "and I'm not gonna let you off the hook, either. _Because_ you know. You know what he's - - why you all exist."

Jay rolls his eyes, looking bored. "Jesus, you're not going to start with _that_ bullshit again, are you? Poor Sammy, life was just too gosh darn hard on him. He just had to make up imaginary friends to keep going."

Kate feels her own rage blooming at the sound of that mocking summary of Sam's wounded life. No amount of reminding herself that Jay's denial serves a purpose can help, not at the moment. His lack of empathy isn't exactly news to her, but it's harder to take when it's turned against Sam. 

She wonders if Sam is hearing all of this, somewhere in the back. Sometimes he does.

Dean seems to be struggling not to lose his temper. "I called it 'imaginary friends' _once,_ Jay. Back when I had no idea what it even was. It was a dick move, and I know better now, okay? And Sam knows that. So don't you quote me back to me. Just because I was an asshole about it, doesn't mean you get a free pass to be one to Sam, too."

Jay shrugs. "Not being an asshole, man. I'm just not buying his story. The guy’s just weak. Always was. Even back when you were kids, he was a fucking whiner -- you know I'm right. He just can't deal, and he fell apart, and now he has a neat little story to tie it all together. He has all of us to point at and say, see, something bad _must_ have happened, otherwise these guys wouldn't be around. I mean, come on, he just can’t handle his shit. That’s all it is, all it’s ever been."

The sheer amount of vitriol in Jay's words sends chills down Kate's spine. _He's gone over this with a fine tooth comb. Has an explanation all laid out about why it all has to be a lie._ Sam's constant self-doubt seems tame in comparison, and she wonders how much of it comes from the same toxic well that Jay seems so content to draw from _._

Feels like it's all coming from the same source. She's become familiar with the radioactive core of self-loathing and self-dismissal that so many of her patients harbor after being emotionally crushed, consistently and from a young age. Sam has that in spades; Jay just appears to have the most direct access to it, and zero qualms about giving it a voice. 

Dean sighs. "Yeah, alright. You've told me that before. It's not - - I mean, for fuck's sake, Jay. If there's something Sam is bad at, it's convincing himself that _anything_ is not his fault. Try telling him that something going wrong is not on him. That's the guy you think is making up excuses? Seriously?" Dean raises an eyebrow as he adds, "and he's definitely not making _you_ up -- it'd be nice if he was, at this point. 'Cause let me tell you, you're a real treat."

That observation produces another eye roll from Jay. "Yeah, well, you're not exactly a joy to be around either, jerk. Get over it." 

He frowns as Dean smiles, and this time Kate has to admit she shares the alter’s sentiment. "What? What the hell's so funny?"

Dean's smile was quick, and it's immediately gone, along with the flash of relief that evidently made it appear. "Nothing," he says, looking past Jay's shoulder at the wall. "It's just - - that's Sammy's word."

Jay's frowns deepens. "What, 'jerk'? Oh yeah, he really coined _that_ phrase. Super unique."

Dean shakes his head. "I know it's nothing special to you, but that's what we do. I call him bitch, he calls me jerk. It's a thing. I was just surprised to hear you say it, that's all."

Jay looks uneasy, like he finds the mere suggestion that he shares anything with Sam upsetting. "Whatever. It's probably because he's around here somewhere, whining away about how he barely got to say hi before we -- before I took the wheel. Like I fucking _wanted_ to."

Dean nods, and Kate wonders if she's imagining the way his face softens, just a bit, at the sound of the alter's protest. "I know you didn't. Listen, I know you have to deal with a lot you didn't ask for.” He pauses, thinking. Bites his lip before he continues.

"Jay, I know -- I know you've had to look out for Sammy and the rest of them all on your own for all this time, and for that - -” Dean's voice cracks as he says the words, but he gets through them, “for that I'm sorry. I am.” Kate feels her heart clench as she watches him study his brother’s eyes, and the half-stranger that's looking through them. “But I'm here. I need you to know that you can stand down, he's safe."

This is the closest Kate has seen Jay get to losing his cool. "Stand down? Are you for real? Man, you really _are_ a hopeless case. You think I'm gonna what, evaporate because you just decided to sail in? Because you finally picked up a damn phone and got an update?” He shakes his head, incredulous. “You do know that's not how it works, right?"

Dean raises his hands. "Woah, hey, I didn't mean it like that. I'm not saying you should just disappear. Or that you _can_. I just meant - - I'm just saying, I'm here. And I'm not going away, and I know you're all pissed about how it went down, but I really want to talk to Sam for a minute. I meant it like that, okay? I meant - - can you - - you said he was around, right? Not that far away right now. Can you try to get him to come back?"

Kate braces herself for another scathing retort from Jay, but he says nothing, studying Dean's face again. 

Eventually he says, "well, whatever, he's going to have to deal with you either way, now that you're here. And I'm not into this reunion shit. I can't just make him stick his head out, but I can - - I can try going back inside, let whoever's up for it take the front. If that even works. I might just be stuck here."

Dean's immediate nod tells Kate how often he's seen that happen with Sam. Has found himself looking at someone in his brother’s complex inner world who didn't want to be there, but couldn't leave. 

Jay walks over to one of the lobby chairs and sits down, leaning his head back against the wall. He rubs his face, looking uncharacteristically tired, almost resigned. But his voice is still sharp as he says, "you're gonna have to be careful, though, if it's one of the kids that comes up. If you make those little fuckers upset, I'm the one who's going to have to deal with them crying for days after. I'm not doing that right now. Shit is messed up inside as is."

Dean's face falls at the sound of that statement, like the mere mention of Sam's younger others being inconsolable hurts. "I'll be careful. I always am, with them. You know that."

Surprisingly, Jay nods. He stays quiet, staring at the ceiling for a few minutes before he finally blinks and shakes his head. 

"I can't go inside. Door won't open."

Kate assumed that would be the case; Sam often refers to his sense that there's a metaphorical gate that he has no conscious control of, one that swings open and closed depending on factors he’s often clueless about. She knows that his system tends to lock itself up when things reach a certain level of instability, leaving either Sam or one of the others alone out in front for long periods of time, escape routes blocked. This is nothing new. The other side of that coin is just as confusing; sometimes his mind responds to overwhelming pain with a flood of switches, with Sam gone for days at a time and his consciousness shifting between alters at breakneck speed. 

Nothing new for Dean, either, apparently. He sits down by Jay, leaning back to watch the ceiling with him, like they're admiring the sky on some field trip rather than staring at a thick layer of pale green paint. "That's alright. We can just sit here for a while."

Jay doesn't argue, which again, catches Kate by surprise. She thinks to herself that, for all his hostility and sarcasm, Jay must still have some form of closeness with Dean that he doesn't with anyone else. There's a level of familiarity that's completely absent from his interactions with her and the rest of the staff. Well, that makes sense.

She watches the two men sitting side by side, motionless and silent. She can tell Dean is alert, monitoring Jay's body language, quietly focused on whatever alter Sam's inner world might send to the front next. Jay, on the other hand, seems to be sinking.

She's seen him do that before, all of them really, but it never ceases to unsettle her -- the slow slide into a sort of twilight consciousness as a system is preparing for a shift. She isn't sure _why_ she finds it so unsettling, exactly; she knows the mechanism of switches, including ones that are painfully slow and gradual. And she doesn't like to feel like a curious spectator of another human being's pain, which she does, right now. Still, she looks on.

Jay's face slowly loses its tension as the moments pass; he's still staring up, but Kate can see his eyes lose their focus, can tell when he isn't really looking at anything anymore. She watches as his fingers stop tapping that frantic rhythm on his knee and his face goes slack; his head tilts, just slightly, like he's no longer present enough to remember to hold it up all the way.

For a while -- seems like forever -- it feels like it's just Sam's body resting on that chair, unoccupied, eyes still open but unseeing. And then, like a liquid poured into an empty glass, there's consciousness again in those eyes. It's unmistakable, jarring almost, especially because it's so clearly _not_ Jay. The person inside Sam's body takes a hitched breath, looks down and around them, eyes widening as their gaze lands on Dean.

The older brother swallows hard, seems to search for his voice for a second or two before he finds it.

"Sammy?"

The man seated next to him shakes his head, eyes filling with tears. Dean angles a quick glance at Sam's hands, at the way the fingers curl in on themselves now anxiously. "Okay. That's okay. Hey, kid. I missed ya."

Evan smiles at that, instantly happy and relieved, and his joy is nothing short of heartbreaking. Kate thinks of how scared he was that Dean had forgotten about him, that he wouldn't want to see him even if he hadn't.

"We missed you too," he says, then hesitates and lowers his eyes before he adds, "where'd you go? 'S not fair. We were worried a lot. And - - and you never came to visit."

The open sorrow on Dean's face tells Kate that he's momentarily forgotten they're being watched. His guardedness is gone, nothing but pain in his eyes and in his voice as he says, "I know. I couldn't, buddy. And for a while I didn't even know you guys were in here. I'm so sorry. It - - it's never going to happen again, I promise you that."

The boy nods, looking unconvinced. "Even if Bobby calls?" 

"Even if God himself calls. Which, you know, possible but unlikely."

Evan seems to take that last assessment to heart, nodding solemnly before his eyes wander again _._ Already distracted.

"We - - I got a name, now," he informs Dean, and Kate has to smile at how proud he sounds to be sharing the news. "You can know it, too. But you can't tell anyone. Just Cas." He thinks for a moment. "Maybe Cas already knows. He comes to visit a lot."

Dean's eyes are pained as he says, "that's good. Cas didn't tell me about you knowing your name now; just about Jay. I'll keep it a secret, if you want me to."

"Evan," the boy says. He tucks his hands under his chin and lowers his head a bit as he utters the word, like he's trying to hide. _He's nervous that Dean won't approve,_ Kate thinks. 

Dean smiles. "That's a cool name. Evan. Okay, so that's good news, right? Now I won't have to keep calling you _buddy_."

Evan looks concerned as he says, "you can - - you can still call me buddy. We don't mind."

"No? You kind of like that nickname, huh."

The boy tries to shrug, but ends up giving him a shy nod.

"Okay then, I'll call you that, too. Is it because you and Cas and me are buddies? Yeah. I get that. No problem."

Evan sighs happily, sliding down in his seat and leaning the side of his head against Dean's shoulder. He stays like that for a few minutes, content to just feel safe, apparently. Kate suddenly wants to cry as she watches Dean's expression, then the way his hand hovers over his brother's head before it recedes. 

Something tells her neither Dean, nor Sam have been taught to show affection, and this small display of emotion feels like something that may not happen too often in either of their lives. But she might be wrong about that. Anyway, the gesture doesn't surprise her; people seem to warm up to Evan quite easily, which is something she's never been able to convince Sam was possible. Sam can barely stand to hear about his Littles at all, much less accept that they might inspire actual empathy, rather than aversion or mockery. 

Evan looks like something has suddenly occurred to him. He sits up in his chair, excited. "Can we make a stop on the way home? I want a strawberry slushie, but they don't have 'em here. Can we go to Biggerson's? And get chili fries, too? Can Cas come?"

Dean's smile at the unexpected barrage of inquiries turns pained again. "Not today, buddy. But soon", he adds, as he sees Evan's face fall. "I'm gonna come see you a whole lot, until then. Okay? And I'll be talking to Kate, too." He looks up at the nurses station, meets Kate's eyes. She isn't sure if she should pretend she wasn't eavesdropping, but she doesn't bother, nodding instead. 

Dean wraps his arm around Evan's shoulder. "Hey, you wanna show me around a little? Maybe introduce me to your roommate?"

Evan considers the offer. "Luke," he says. "He's a good roommate. Yeah. He likes us."

"Oh yeah? That's good. I like _him_ , then."

Evan looks troubled as he says, "but he's sad today, though. When he's sad he's too tired. He doesn't wanna talk."

Dean nods. "Yeah, been there. That's alright, I won't bug him. But you can still show me your room, or maybe the stuff you guys make -- do you make stuff in here? Like, I don't know, macaroni necklaces or something?" 

Evan is already up on his feet, heading for his room. "Yeah, dragons," he says, and Kate feels the need to elaborate as Dean follows him, looking at her like _what the hell is this kid talking about._ "He's been drawing a lot," she says, "and he's extra proud of one of his works. He's been excited to show it to you."

The smile that Dean gives her is genuine, this time. "Oh. Right. His dragons."

As she watches the older brother make his way down the hall, Kate finds herself hoping that Evan won't tell him about how the dragon keeps him safe while he sleeps. She has a feeling that Dean is no stranger to growing up with that particular worry. 

She needs to work out a new plan for Sam's release, now -- to go over her schedule to try and find as many time slots to meet with the older brother as possible, in the time they have left. To rethink Sam's possibilities outside.

As she sits at her desk, staring at Sam's open file on the computer screen, she wonders if what she's feeling is hope. It's not like Sam suddenly has access to relevant therapy now that Dean is back; not like all that trauma isn't still waiting to be dealt with. 

But she can't help but wonder if Dean's return gives Sam more of a fighting chance. 


	9. Chapter 9

**Summary for the Chapter:**

> Not even sure why I thought I needed to split today's update into 2 chapters, but my brain is fried from pain right now. Plenty of triggers of the variety mentioned in the fic summary, as well as the mention of emotionally & physically abusive parental behavior. Can't think beyond that, so tread lightly.

*

There's something about complete silence in group that makes it almost intolerable. A room full of people saying nothing is like a loaded gun -- at least it is today. 

Kate can tell Zach isn't loving the situation, either. She exchanges glances with him -- _let it brew, this means something, just wait --_ but even before he opens his mouth, she knows it's a lost cause. Not a good day for Mateo to be on sick leave.

"Doesn't usually get this quiet in here," Zach says, and Kate watches as a few people nod. Others keep their eyes down. 

Heather clears her throat. "I'm sorry if I - - maybe this wasn't the right thing to bring up in group." 

Kate raises her hand. "It really is. I think it's important. And I feel like many people in this room can relate, which might be why it's gotten so quiet."

Heather shrugs. "I guess. I don't know. It's just - - I don't know if I can - - umm." She smiles sheepishly. "Sorry, I lost my train of thought."

"You were saying that you miss feeling like you're part of a unit. A family."

Heather sighs. "Right. And it's not like I don't _have_ any family, on paper. We're just not - - not really connected."

"In what way?" 

"Well, my brothers and I barely speak. And my parents - - I don't think I was ever what they expected." The young woman moves uneasily in her seat, her eyes lowered. "I don't know what kind of kid they were hoping for, but I wasn’t it. And they let me know."

Kate studies the faces of everyone sitting in the circle as Zach gently says, "things got rough."

"No. I mean, sometimes. Not physically, at least not that much. But they really - - I really felt like they hated me. Like I was messing up their whole deal. All these issues, all the anxiety, all the things they had zero patience for. I was exhausting to them. I stuck out like a sore thumb in that house."

"And they let you know this how?"

 _We really need to have a one-on-one later about tact,_ Kate thinks, but all she can do right now is smile encouragingly at Heather as she struggles with the words.

"They - - well, they'd tell me. And I think if I had half a brain in me I would have kept quiet and, you know, not given them more to work with. But I never could. I got really combative after a while. That got me punished. Like, a lot."

The effect of the last sentence on a few of the participants isn't lost on Zach, and Kate appreciates it when he says, "we don't need to go into too much detail about that in group, but I _would_ like to hear a little about how it made you feel. To constantly be punished."

As Heather considers what she wants to say next, Kate finds herself watching Sam's expression. She's been observing him extra closely since Dean started visiting on a daily basis -- which, she still has no clue how he secured _that_ unusual permission, but she has the sneaking suspicion that it's better not to look too much into it. 

Anyway, she's been watching Sam this entire week. She's well aware that they're at a dangerous juncture; that having his brother back might throw open some doors that Sam's mind has managed to keep closed before, when he didn't have the safety of Dean's presence in his life. She hopes she's wrong, because they don't have the time to process anything new that might come up. Sam's time limit here doesn't take into consideration therapeutic progress, not really, and she's used up whatever leverage she had with Adams. She is left with watching and worrying.

Apparently, with good reason. Sam was fidgeting before, which is pretty much his go-to reaction when parental conflict comes up in group. But he isn't moving now; he's looking intently at Heather, his eyes wide and unblinking.

Which is, again, how Kate can see it happen. She sees the shift as Heather says, her voice low, "well, they -- my mom used to lock me up sometimes. We had this closet - - yeah, I probably shouldn’t go into that."

As Zach tries to navigate the conversation to slightly safer ground and sidestep the actual details, Kate can tell it's too late for Sam. She can almost hear something click, like an actual trigger has just been pulled; Sam's eyes go distant, no longer focused on Heather. He doesn't move or make a sound, but Kate can see his closed fists loosening in his lap, his mouth dropping slightly open. Drifting away and into some memory that's too painful to face. _Stop stop no wait - -_

But there's no unringing that particular bell. As she helplessly watches Sam get pulled under, the discussion continues; people chime in about their own place in their original families, about siblings who had to pick a side, about a loneliness that became too overwhelming way too early. 

Sam doesn't speak during the quick round they do before the end of the group session. He nods blankly when Zach asks if he's feeling okay, but neither of them is sure if he actually understands what he's being asked. 

As Luke practically leads Sam out of the room, Kate reminds herself that there's not much she can do. Sam will be out in the world in no time; she won't be there to catch him when he falls. Letting him figure his way out of situations like this is the only support she can provide him with at this point. Which she hates with a passion. 

She shares her thoughts with Zach when he comments on how dazed Sam seemed; tries to find reassurance in the fact that Zach agrees with her about having to wait and see. They go through their session notes, sum things up, the usual routine. 

She can't chase away the feeling, though, that there's something ominous about how immediate Sam's response was to Heather’s mention of being locked up. It makes her wonder about what old wires may have tripped. Who it was that once had Sam trapped, jailed, maybe literally.

Takes her about fifteen minutes of staring into her coffee to realize that she's not going to get much done today unless she checks on him. _Just a quick talk,_ she tells herself, _just see that he's surviving this like he always does, and then you move the hell on._

She rolls her eyes at her own worry as she walks down the hall. And then chokes back a curse as she opens the door to see exactly what she was hoping not to find. 

*

Sam is lying on his bed, motionless. His eyes are two dull, frozen lakes in this light, open and unseeing, tears still pooling between unmoving eyelashes; he must have been crying just before he stopped blinking. He does that when he recedes too far in, sometimes -- just seems like he forgets to blink. There's something about him losing even that tether to his body that makes the situation feel absurdly urgent to her, like the thing he'll lose next is remembering to breathe. She knows that's not true, that these shutdowns don’t work that way, but it sure as hell _feels_ like they might _._

She’s watched him check out like that the first time they had to suture his wounds in the ward, one especially bad night, to avoid sending him to the ER. Jay was gone by the time they could get to it, so it was Sam who went through that. And though he’s far from squeamish, _something_ went wrong halfway through, because he was suddenly gone. Like he completely left his body, with no one else taking the wheel that time.

She remembers the doctor on call trying to rouse Sam when they finally had to send him to the ER anyway, remembers the way Sam just flopped against the gurney as that clueless, overconfident prick tried shaking him to bring him back. She gave the guy a piece of her mind, but being manhandled like that while he was helpless pretty much made sure that Sam wouldn't resurface. And he didn't, not for hours. Her shift was almost over by the time he was truly conscious again.

She hates the thought of another one of those episodes, but yet again, there's only so much she can do for him right now, if anything. Which might be the hardest part to make peace with. And she knows she'll still struggle to bring him back; some defeats are unacceptable.

She's tried to ask him about what he remembers from those dead moments (hours, a full day once, on his first week here); has done her best to find out whatever she could, careful but insistent. Sam isn't her only dissociative patient who shuts down like that. She actually sees these episodes often, probably because people are at the peak of their pain when she meets them here, running on empty. And for some reason she can't leave it alone, can't accept not understanding what exactly goes on underneath that unresponsive blankness, that absence. 

Sam's face when he shuts all the way down makes her think back to a drawing she saw on one of those listicle websites, one day on the train. The post was something like _25 Images That Will Keep You Awake Tonight_ , or something else equally clickbaity. And most of it was what you’d expect -- creepy statues, disturbing old portraits-- but even on the smudgy screen of her old smartphone, one of the images was jarring enough to actually make her stop scrolling. A beautiful sky over a serene seascape; a boat resting lazily on the water, its occupants laughing and lounging in the sun; a dark underworld of nightmarish sea monsters filling the entirety of the ocean below, beaks and claws and tentacles and teeth pressed against the glassy surface, not one of them breaking through. 

She's seen that sort of visual metaphor for the subconscious before, but that one image still got to her. It dug in like a thorn, persisted in her memory, and now it comes up whenever she wonders about what happens to her patients as they get pulled under like that -- what ancient horrors they share their own deep waters with. 

Sam’s switches she can handle, but on the few occasions when his lights seemed to just go out, it was impossible for her to make peace with not knowing. Because sure, he might be gone, out of reach and momentarily protected even from his own pain; but he might also be struggling just under that calm, blank surface that only reflects her worry back at her, mute and impassive. 

It's first and foremost instinctive worry and sorrow that she feels when this happens, but she also needs to better understand these states as a therapist; knowing what's actually going on beneath that silence determines how to go forward. Whether you intervene, or give a patient some time until their mind somehow knows it’s safe for them to be present again. This isn't just true for Sam's case, either.

But she’s never gotten a real answer from Sam about what exactly happens to him during these shutdowns. He doesn't seem to know.

Either way, it’s as disturbing as ever to watch; there’s a helplessness in witnessing it that she can’t tolerate. She feels so goddamn _useless_. Something can be done when Sam is in other kinds of crisis, no matter how challenging -- like when he can’t quite wake all the way up from one of his nightmares; when he remains terrified, half-asleep, trying to escape. _That_ doesn’t scare her -- a 200lbs man barrelling down the ward hallway, irrational with fear, she can handle just fine. She can spring into action then. Use grounding techniques, talk him through the maze. 

But it’s when Sam is clearly, painfully awake and still unreachable, that she has to remember what brought on his condition in the first place; that this man has been through something so persistently agonizing that he’s had to _learn_ how to do this. That something in him has taught itself to be there in body only. 

Watching him like this only makes it clearer than ever that he was, at one time, truly and hopelessly trapped -- and worse still, that it would have happened when he was just a child. DID forms painfully early, sometimes decades before it makes its presence fully known. And Sam going absent like that -- not switching, but becoming practically catatonic and _gone_ \-- is a devastating reflection of his younger self, a child who had nowhere to go but oblivion.

It’s not a notion that gets easier to revisit, even though it's her job to gently help Sam accept the possibility that this is how his condition was formed. That this isn't some accident, or something he was randomly born with. 

Sam's evasiveness about his childhood may not be conscious avoidance as much as it is pure amnesia; if his memories from growing up are that few and far between, that alone is a red flag for possible trauma, and she's been honest with him about that. But it's not just that. What little he does know and does share feels toxic in a way that she’s long ago learned to recognize. 

Beyond his circumstances, beyond what sounds like neglect and tragedy in the immediate family, there's a sense that some adults in his life -- she isn’t sure in which circle, yet -- weren't quite _right._ She has little doubt that at least one alter is carrying far worse memories for him, though none of them seems to feel safe enough to share them at this point. Which makes total sense to her.

Either way, right here and now, she has to decide. And she lands on the side of trying to bring Sam back. They don’t normally try to force him back to the surface when one of the others is there, not unless there’s real danger to his well being; his alters need their time, too. But this emptiness, this non-responsiveness, worries her. Finding Sam like this means that something in the discussion sent him into a spiral of distress so severe, so unrelenting, that all his system could manage was to shut down as many facets of awareness as possible. 

She tries calling his name, and when that doesn’t work -- which she expected -- she takes a risk. “Sam, I'm going to place my hand on your arm, okay? There we go. Can you feel this? Can you hear me?”

Sam's ten thousand yard stare doesn’t meet her eyes; he doesn’t make a sound, not yet. He does give her the hint of a flinch, though, and that’s a sad, small comfort. Maybe he’s not as far away as he appears to be. 

She thinks back to the first time she ever saw this happen. How much it scared her, how helpless she felt. 

The patient was a man in his late twenties, arms and chest lined with scars from years of apparent self-injury that he said he didn't really remember. The staff was suspicious -- it was back during her first rotation, in the ER rather than a psych ward, so awareness of that kind of complex post-traumatic amnesia was about as non-existent as you'd expect -- and Kate remembers having trouble believing him. She didn't know much about dissociative disorders then, certainly not about the high end of that spectrum. 

And so she nodded with an inner raised eyebrow when the man told her he had no memory of how he got his most recent injury, either; she reported nothing to the nurses and to her supervisor when she saw the patient's gaze drift off and his face change mid-conversation, just as he was asked about his home life. When she saw him looking around like he was taking in his surroundings all over again. When he seemed not to know who Kate was, but wouldn't acknowledge it. 

_He's stressed and confused, that's all. You're not going to suggest that this patient has fucking multiple personalities. No one here will ever take you seriously again._

She didn't say a thing. Played it safe. And she went on to deal with other patients during the never-ending wait for someone from Ortho to come down and take a look, determine if the tendons in the young man's right arm were damaged enough to require surgery. When hours passed, she found herself avoiding what she knew she needed to do: get on the phone, nag the attending to get his ass down there. Barring that, she could go see how the patient was doing, at least. 

_In a minute._

When she finally did walk over to the corner of the room to draw the curtain and check on the guy, it was because Anna, a resident and a friend, came down to do a psych eval. And by then there was pretty much no one to talk to. She'd never seen a patient go that dead-eyed, that still, without losing consciousness; watching Anna try to communicate with the man, then give up and call upstairs to check for an available bed, was beyond disturbing.

"What the hell _was_ that?" She asked Anna later, as they shared a rare coffee break out in the hall. "I don't think I've ever seen someone in that sort of... state."

Anna sighed. "Yeah, that kind of non-responsiveness can be scary. Might be something called a dissociative stupor. It's hard to define, really depends on who you’re asking, but I think that's what we're dealing with here. It's like the mind's way of protecting itself when there's extreme emotional overload, like… like the mental equivalent of fainting from extreme physical pain, I guess."

She shook her head, watching the ER doors. "It'll fade away, but you guys need to keep an eye on him while he's like this. Makes patients vulnerable, and I don't need to tell you this but I'll say it anyway, lots of predators are opportunists. I got someone kicked out of here last year for trying to take advantage of a situation like that."

Kate's skin crawled at the thought. "Shit, really?"

"Yeah. These bastards are like sharks, they home in on vulnerability. You'll see, if you're serious about specializing in trauma. Severely dissociative patients have to deal with a _lot_. I mean, not all of them deal with the same exact shit, obviously, but you know." She shrugged, looking down at her cup."The world isn't a kind place as it is. It can be a fucking snake pit when your brain has the habit of shutting down on you."

Anna was right, of course. Kate learned how much she was right. But back then, she hadn't yet heard story after heartbreaking, enraging story about people being abused at their most vulnerable; she wasn't quite as jaded yet. She did keep an eye on the man as much as she could, though. And he was alert and coherent again later that night, which made them cancel his move to psych. He wasn't staying; they rarely do.

She also remembers the guy's face when she asked him if he had anyone she could call for him, anyone he could talk to. He said no; that there were people in his life, but no one who really knew. No one in the waiting room. No one he felt like he could call. She didn't know it then, but that, too, would turn out to be something she'd hear over and over from her patients, especially (though certainly not exclusively) ones with DID. 

Sometimes the persistent unfairness of prolonged trauma, of how isolating its aftermath can be, how punishing, is almost too much to consider. She often thinks about how it feels to actually _live_ that unfairness. To see that shadow of disbelief on way too many faces, to experience the way in which so many people drift away, unable to contain the pain and chaos _._

She’s become deeply familiar with that heartbreaking pattern and the many, many factors that are woven into it, interpersonal and cultural. Some of her more sociable, outgoing patients do maintain a circle of close friends and support, but the rule usually seems to be that, the more devastated you are, the lonelier you find yourself. People’s patience and compassion in the face of constant, severe crisis tend to wear thin after a while, relationships tend to become imbalanced, to not last. And that’s another reality that many of the people she meets in the ward have come to expect. 

“No one stays,” one of them told her once, and she didn’t know how often she’d hear -- and think -- that phrase. Definitely not for all of her patients, but for too many.

Sam's blinks are coming faster now, the rhythm of his breathing is slightly different. It's like watching ice thaw, slow but undeniable. Kate can see awareness seeping in, can tell that he’s coming back. She wonders how long he'll be present before he's snatched away and pushed to the back again. At least if one of the others is in control there's someone there; better than this emptiness.

When Sam finally turns his head to her, his eyes struggling to focus and his lips forming a question he doesn't have the words for just yet, she smiles at him.

"Hey there. You're okay, take it easy. Just breathe."

Sam is slow to react, clearly finding her words hard to comprehend. He blinks at her again, tries to sit up, but can’t seem to. He sinks back into the mattress, looking bewildered. 

She‘s seen this, knows the body takes a while to find its sync after being forced into a state of near-unconsciousness. It can be a slow climb back up from that lowland, sometimes. “Sam, give it a sec, okay? Just keep looking at me, for now. Let's work on that eye contact".

Sam obeys, studying her face like he can’t quite remember what a face is, his eyes slowly regaining focus. After a few minutes of this, and the occasional, soft “hey, stay with me” when his gaze starts to drift again, something seems to finally connect. He takes a hitched breath, and she can see that final part of his awareness filter back in. See that weight start to settle, a heaviness that follows initial recognition.

“Hi,” she says, and as Sam struggles up again, leans on his elbows and rasps a tired “hey,” she’s relieved beyond what she could have expected. 

“You were out of it for a little while. How are you feeling?”

Sam doesn’t seem to know how to answer that, looking around the room, gaze landing on his roommate's empty bed.

"Where's - - " he struggles with the name, and Kate resists the urge to help him. She watches him search his memory. This, too, is a way of pulling him back from where he just was; another thread he needs to pick up.

"...Luke. Where's Luke?" 

_Good._ "I think he's in session with his therapist. Or maybe in group. Why?"

Sam struggles to sit the rest of the way up, succeeds this time. Lowers his feet to the floor. "What time is it?"

"Almost noon. There’s still half an hour before lunch. Think you’ll be up to eating in the dining room, with everyone? I think that might do you some good." Too much information all at once; she should know better. She can imagine Jay’s voice, _let the guy come around before you start bombarding him like that, what the hell, doc._

Sam blinks at her. “Huh?”

Kate waves her hand. “Never mind, forget it. I’m just glad you’re talking.” She wants to say _glad you’re awake, glad you’re responsive, glad you came back this time_. She wonders if Sam senses how deep under he just was. Maybe he can feel it, somehow.

There’s no time to contemplate that, though, because it’s then that his head begins to slump. Still not all the way out of the woods, apparently. _Shit._

She reaches out, doesn’t warn him this time, just grabs his arm. “Sam.”

He flinches, looks up at her like he thinks he’s in trouble. “S- sorry. What - - ”

“Don’t fade on me, okay? Let’s try to keep you focused. Can you stand up? Maybe walk around the room a little?”

Sam bites his lip, nods. “Yeah.” 

She watches as he gets up slowly and walks over to the window. His balance seems a bit off, but that’s to be expected. Okay. 

Luke chooses that moment to storm into the room. “Shit, man, I - - woah, sorry, didn’t know you were in here. Should I - - do you need me to --” He gestures towards the hall.

“No, it’s your room. That’s okay. I was checking on Sam, but he’s doing a little better now, so I’m going to leave you guys alone. Sam, keep walking for a bit, okay? Don’t lie back down yet. Try to stay focused.”

Sam looks away from the window, tries hard to smile. “Promise.”

Luke’s raised eyebrow tells her he’s on the case. His protective streak is strong as it is, but nothing catches his attention like Sam’s bad spots. He knows his roommate well enough to figure out, especially after Heather’s words in group, what Sam is struggling to come back from.

“See you at lunch,” he says as she makes her way out, and Kate doesn't have to turn around to know that he’ll be spending the time left until then making sure that Sam is up and talking. 

_Sam’s got some good friends in here,_ she thinks, and the warmth of that knowledge lasts a full 30 seconds before the thought of release dates and zero safety nets dumps the usual bucket of ice water on that rare comfort.

She makes it a point to pass by the small dining room later, and she catches a glimpse of Sam at the table in the back -- he always picks the back, since day one, by the window and with no one sitting behind him -- and she is intensely grateful to see that he's smiling. A pale, tired smile, but still. 

Luke is knee-deep in what appears to be less of a story, and more a true-to-life dramatic reconstruction of some incident he had in a bar once, arms waving. People around him seem unfazed, familiar by now with his particular brand of storytelling style and more interested in their meal; but Sam clearly appreciates the distraction, and he's actually laughing now, fork in hand, looking almost okay. It's hard to believe that he was unresponsive and stone still less than an hour ago.

Tha sort of change is the one constant that Kate feels like she can count on. Jay once told her, _if you don't like Sam, wait five minutes._ Leave it to Jay to put it like **that**. But she finds it hard to truly be relieved as she watches her patient climbing up from yet another abyss. 

Because she wants so much more for Sam. She wants a life where his mind doesn't have to turn itself off and leave him dead to the world because someone, at some point in his life, thought locking up a scared child was a good idea. She wants a life for this man where he doesn't have to guess when he last took a shower or how he slept; where questions like what day it is, or whether he's eaten today, aren't a challenge. 

And some days, like today, she wishes she could go back in time and face whoever did this to him. 

She sighs as she enters the nurses station, where Megan is filling up a row of tiny paper cups in the medication tray. The nurse looks up at her. "Well _that's_ not a happy sound."

"Huh?"

"Nothing. We still on for tonight?"

"...Tonight?"

Megan raises a critical eyebrow at that. "First Tuesday of the month? Horror flick night? Ring a bell?"

 _Oh_. "Shit, yeah. Sorry. Yes, absolutely. At around 8, maybe -- that okay? Wait, I haven't picked anything. Sorry, I'm all over the place this week."

"Really, couldn't tell. That's okay, I'll find us something. I can bring some junk for us to munch on, too. But you better feed Angus his catnip, I'm telling you right now. I WILL be shrieking and grabbing you and Kiran every 30 seconds, you know that."

Kate laughs. "Oh, I _know_."

Megan shrugs, marking the meds on her chart. "Hey, not even gonna apologize -- this was your bright idea. You want me there, busted eardrums are the price of admission". 

"Yeah, yeah."

"So are you clocking out?"

Kate nods. "Yeah, in a minute. Anything you need me to do before I go?"

Megan hesitates before she says, "No, but I - - I just wanted to show you something."

"Sure, what?"

The nurse opens the bottom desk drawer, takes out a folded piece of paper, hands it to her carefully. "Have a look at this."

It's a drawing of what looks like a stick figure of a man, arms and legs decorated with stains of red watercolor. The entire page has been painted grey, the now-dried water making the paper wavey and crisp. There's a big circle of black filled in around the human figure; the watercolor must have proven insufficient, because it's painted over with crayon, and with such force that the page is slightly torn. The man's face is all eyes, no mouth or nose. She has no idea how it still manages to look so sad with just those two black dots, but it does.

She has to squint at the text scrawled in the corner of the page to read it; the small letters written in pencil say _SAMY IN THE HOL._

"Makes the little hairs on the back of your neck stand up, right?" Megan shakes her head, looking troubled. "Poor kid."

Kate's eyes are still stuck on the text. "Yeah, that's an understatement. Did Evan draw this?"

"No, someone younger. And very scared, too -- they couldn't talk."

Kate tears her gaze away from the paper. "Wait, when was this?"

"Last night. I meant to show you this earlier, but it sort of got away from me. Zach was on night shift, and he found Sam hiding under the bed. Well, I mean he -- or whoever it was at the time -- was _trying_ to hide under the bed. Probably didn't know how tall Sam was."

Kate sighs. "Yeah, they forget. And then what?"

Megan's eyes soften as she says, "Zach got him -- her? I don't know -- to come sit with him in the station. Brought them some paper and all kinds of stuff from Art, to keep them busy. Looks like it worked."

They both stare at the drawing for a while.

Megan speaks first. "What do you think that means, 'Sammy in the hole'?" 

"I don't know. Nothing good."

The nurse sighs. "Yeah, that's pretty clear. You want that for his file?"

Every cell in Kate's body says _no, no thank you, no need for one more image of what this tortured man has been subjected to._ But she reaches out, takes the piece of paper. Folds it up neatly.

"Yeah, I'll take it."

*

**Author's Note:**

> *Takes a deep breath*  
> I won't go too much into my reasons for wanting to add to the body of fanfic works out there that deal with DID/OSDD, but suffice to say I'm mostly a "write what you know" type of person. I'm admittedly pretty limited that way. I'll just... leave it at that. 
> 
> Anyway.  
> The physical and emotional reality of SPN already lends itself to the premise of surviving severe trauma, right? So this fic is one more possible outcome of that world. This Sam may have suffered an even more traumatic upbringing than he did in canon, though the nature of it is not specified. If you know people with DID or are one, you're well aware of how compartmentalized certain memories can be, and why. 
> 
> **A few words about the way DID is portrayed in this particular fic, if you're at all interested:**  
>  Dissociative Identity Disorder is often a very hidden condition, and also one that appears in many variations. This might come as a surprise to many of us who've only ever encountered extreme, one-dimensional representations of DID in popular culture. The narratives we’ve all been consuming over many decades present a very specific, unified picture of what DID is like. 
> 
> The fic deals with a level of DID that resides somewhere in the middle of the disorder's wide spectrum, which is admittedly challenging to write about; and it occasionally touches on some less-discussed issues that have been on my mind regarding DID and OSDD. Not as part of some mission statement, just because, like I said, I write what I know or have encountered. So there's some co-consciousness; there's toxic self doubt; there's the unbelievably common experience of facing uninformed professionals; there are states of mixed or unclear alter presence; and other issues that don't often get addressed in major DID narratives, least of all in TV and film. I get why that happens, btw. This was not easy to write. 
> 
> While the POV in the fic is that of Sam's therapist in the ward, I do feel like I have to mention that I am not a therapist myself, and so I'm sure that my attempt at telling the story through that lens is deeply flawed. I also don't live in the States, so I'm sure my own experience with how psych wards work is very different from how they function over there.
> 
> *If you live with DID/OSDD, first of all, sending you so much empathy in this long, hard battle. I know how this world can make you feel isolated, sometimes maligned. Second, I want to reiterate that this fic doesn't claim to represent all levels of DID, just one.  
> DID can come in way more heightened forms, and in way more subdued forms, too. If this one random narrative connects, if it echoes your experience, I'm so glad. If it doesn't, know that this doesn't mean your experience is being invalidated. This is not an idea of what it “should” look like. In the same way, say, one relationship story can't possibly represent all relationships.
> 
> It's crucial to me to state this because I know how many people with DID (and people with trauma in general) are painfully sensitive to erasure, following a lifetime of interpersonal and cultural dismissal. So please, know this. No one narrative of DID can reflect all of its variations; trauma-related disorders are hugely influenced by the individual trauma that formed them, and by circumstances during and after. You and your unique experience are valid.


End file.
